Significance of coronary calcium score in the diagnosis of coronary arterydisease in patients athigh risk with anegative stress test

Abstract FRE

Aim: The significance of the coronary calcium score (CS) as to its correlation to coronary artery disease (CAD) has been well studied, however, its significance in adding information to asymptomatic high risk patients with negative stress test has not been investigated.The aim of our study was to look at this specific population and find out what was the significance of adding CS to a negative stress test.

Materials and methods: A retrospective study was conducted on 134 consecutive asymptomatic patients who had a stress test, coronary scan and CS in the Cardiovascular Department of Notre-Dame de Secours University Hospital (NDSUH).

These patients had to have in addition to a negative stress test at least two risk factors for CAD.Patients with known CAD and those with bad quality coronary scans, or any kind of invasive cardiac procedures, were excluded.

Stress test results, coronary scans results and CS were reviewed.For the 2x2 tables analysis, a χ2 test was used.

Results:Of the 134 patients, 96 had no significant CAD defined as ≤≤50% luminal stenosi, and 96 had a CS < 40.Of the 96 patients with no significant CAD, 41 (43%) had a CS = 0.Of the 41 whithout a CS, 39 (95%) had normal coronary arteries.

Statistical analysis showed that CS < 40 excludes significant CAD, with a sensitivity of 100% and a specificity of 95.05%, and that normal coronaries could be predicted by a CS = 0 with a sensitivity of 97.5% and a specificity of 96.72%.

Note that the mean of CS ≥ 40 for patients with significant CAD on coronary scan is 125.9 ± 99.4.

Conclusion: A CS < 40 excludes the presence of significant CAD and a CS = 0 is a highly predictive value of normal coronary arteries (