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Prognostic value of coronary artery calcium score and coronary CT angiography in patients with intermediate risk of coronary artery disease.
Int J Cardiovasc Imaging. 2012 Aug; 28(6):1547-56.IJ

Abstract

The aim of this study was to compare the prognostic value of coronary calcium scoring and coronary computed tomography (CT) angiography in assessing the cardiac risk and its temporal characteristics in patients at intermediate pre-test likelihood of coronary artery disease (CAD). Cardiac CT was performed in 326 patients at intermediate (15-85%) pre-test likelihood of CAD to evaluate calcium score and presence and severity of the disease. Patients were followed-up for the occurrence of major cardiac events (cardiac death, myocardial infarction, and unstable angina requiring revascularization). During follow-up (26 ± 12 months) 34 events occurred. Calcium score, extent of CAD, and plaque extent and distribution were higher (all P < 0.001) in patients with events than in those without. No patients with calcium score of 0 had events at follow-up. Calcium score (P < 0.001), number of segments with non-calcified or mixed plaque (P < 0.05), and segments-at-risk-score (P < 0.005) were independent predictors of events. Cardiac risk was greater for all time intervals and accelerated more over time with worsening of calcium score. In presence of coronary calcium, significant CAD further increased the probability of failure for all time intervals. Therefore, patients at intermediate CAD risk without coronary calcium do not need further evaluation with longer and higher-radiation-dose protocols, while in the presence of coronary calcium CT angiography is useful to further stratify patients.

Authors+Show Affiliations

Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University Federico II, Naples, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21922205

Citation

Petretta, Mario, et al. "Prognostic Value of Coronary Artery Calcium Score and Coronary CT Angiography in Patients With Intermediate Risk of Coronary Artery Disease." The International Journal of Cardiovascular Imaging, vol. 28, no. 6, 2012, pp. 1547-56.
Petretta M, Daniele S, Acampa W, et al. Prognostic value of coronary artery calcium score and coronary CT angiography in patients with intermediate risk of coronary artery disease. Int J Cardiovasc Imaging. 2012;28(6):1547-56.
Petretta, M., Daniele, S., Acampa, W., Imbriaco, M., Pellegrino, T., Messalli, G., Xhoxhi, E., Del Prete, G., Nappi, C., Accardo, D., Angeloni, F., Bonaduce, D., & Cuocolo, A. (2012). Prognostic value of coronary artery calcium score and coronary CT angiography in patients with intermediate risk of coronary artery disease. The International Journal of Cardiovascular Imaging, 28(6), 1547-56. https://doi.org/10.1007/s10554-011-9948-5
Petretta M, et al. Prognostic Value of Coronary Artery Calcium Score and Coronary CT Angiography in Patients With Intermediate Risk of Coronary Artery Disease. Int J Cardiovasc Imaging. 2012;28(6):1547-56. PubMed PMID: 21922205.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of coronary artery calcium score and coronary CT angiography in patients with intermediate risk of coronary artery disease. AU - Petretta,Mario, AU - Daniele,Stefania, AU - Acampa,Wanda, AU - Imbriaco,Massimo, AU - Pellegrino,Teresa, AU - Messalli,Giancarlo, AU - Xhoxhi,Evgjeni, AU - Del Prete,Giuseppina, AU - Nappi,Carmela, AU - Accardo,Domenico, AU - Angeloni,Francesco, AU - Bonaduce,Domenico, AU - Cuocolo,Alberto, Y1 - 2011/09/16/ PY - 2011/05/31/received PY - 2011/09/09/accepted PY - 2011/9/17/entrez PY - 2011/9/17/pubmed PY - 2013/3/23/medline SP - 1547 EP - 56 JF - The international journal of cardiovascular imaging JO - Int J Cardiovasc Imaging VL - 28 IS - 6 N2 - The aim of this study was to compare the prognostic value of coronary calcium scoring and coronary computed tomography (CT) angiography in assessing the cardiac risk and its temporal characteristics in patients at intermediate pre-test likelihood of coronary artery disease (CAD). Cardiac CT was performed in 326 patients at intermediate (15-85%) pre-test likelihood of CAD to evaluate calcium score and presence and severity of the disease. Patients were followed-up for the occurrence of major cardiac events (cardiac death, myocardial infarction, and unstable angina requiring revascularization). During follow-up (26 ± 12 months) 34 events occurred. Calcium score, extent of CAD, and plaque extent and distribution were higher (all P < 0.001) in patients with events than in those without. No patients with calcium score of 0 had events at follow-up. Calcium score (P < 0.001), number of segments with non-calcified or mixed plaque (P < 0.05), and segments-at-risk-score (P < 0.005) were independent predictors of events. Cardiac risk was greater for all time intervals and accelerated more over time with worsening of calcium score. In presence of coronary calcium, significant CAD further increased the probability of failure for all time intervals. Therefore, patients at intermediate CAD risk without coronary calcium do not need further evaluation with longer and higher-radiation-dose protocols, while in the presence of coronary calcium CT angiography is useful to further stratify patients. SN - 1875-8312 UR - https://www.unboundmedicine.com/medline/citation/21922205/Prognostic_value_of_coronary_artery_calcium_score_and_coronary_CT_angiography_in_patients_with_intermediate_risk_of_coronary_artery_disease_ L2 - https://doi.org/10.1007/s10554-011-9948-5 DB - PRIME DP - Unbound Medicine ER -