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Coronary calcium score and computed tomography coronary angiography in high-risk asymptomatic subjects: assessment of diagnostic accuracy and prevalence of non-obstructive coronary artery disease.

Objectives: The aim of the study was to compare the coronary artery calcium score (CACS) and computed tomography coronary angiography (CTCA) for the assessment of non-obstructive/obstructive coronary artery disease (CAD) in high-risk asymptomatic subjects.Methods: Two hundred and thirteen consecutiv...

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Published in:European Radiology Vol. 20; no. 4; pp. 846 - 855
Main Authors: Cademartiri F, Maffei E, Palumbo A, Seitun S, Martini C, Tedeschi C, La Grutta L, Midiri M, Weustink AC, Mollet NR, Krestin GP, Cademartiri, Filippo, Maffei, Erica, Palumbo, Alessandro, Seitun, Sara, Martini, Chiara, Tedeschi, Carlo, La Grutta, Ludovico, Midiri, Massimo, Weustink, Annick C
Format: Journal Article
Published: Springer Nature Apr2010
Online Access:View this record in EBSCOhost
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      dt: Apr2010
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      pub: Springer Nature
      place: New York, New York
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        atl: Coronary calcium score and computed tomography coronary angiography in high-risk asymptomatic subjects: assessment of diagnostic accuracy and prevalence of non-obstructive coronary artery disease.
      aug:
        au:
          Cademartiri F
          Maffei E
          Palumbo A
          Seitun S
          Martini C
          Tedeschi C
          La Grutta L
          Midiri M
          Weustink AC
          Mollet NR
          Krestin GP
          Cademartiri, Filippo
          Maffei, Erica
          Palumbo, Alessandro
          Seitun, Sara
          Martini, Chiara
          Tedeschi, Carlo
          La Grutta, Ludovico
          Midiri, Massimo
          Weustink, Annick C
        affil: Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy
      sug:
        subj:
          Calcinosis Epidemiology
          Calcinosis Radiography
          Coronary Angiography Statistics and Numerical Data
          Coronary Arteriosclerosis Epidemiology
          Coronary Arteriosclerosis Radiography
          Tomography, X-Ray Computed Statistics and Numerical Data
          Adult
          Aged
          Female
          Italy
          Male
          Middle Age
          Prevalence
          Risk Assessment
          Risk Factors
          Young Adult
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objectives: The aim of the study was to compare the coronary artery calcium score (CACS) and computed tomography coronary angiography (CTCA) for the assessment of non-obstructive/obstructive coronary artery disease (CAD) in high-risk asymptomatic subjects.Methods: Two hundred and thirteen consecutive asymptomatic subjects (113 male; mean age 53.6 +/- 12.4 years) with more than one risk factor and an inconclusive or unfeasible non-invasive stress test result underwent CACS and CTCA in an outpatient setting. All patients underwent conventional coronary angiography (CAG). Data from CACS (threshold for positive image: Agatston score 1/100/1,000) and CTCA were compared with CAG regarding the degree of CAD (non-obstructive/obstructive; </>or=50% lumen reduction).Results: The mean calcium score was 151 +/- 403 and the prevalence of obstructive CAD was 17% (8% one-vessel and 10% two-vessel disease). Per-patient sensitivity, specificity, positive and negative predictive values of CACS were: 97%, 75%, 45%, and 100%, respectively (Agatston >or=1); 73%, 90%, 60%, and 94%, respectively (Agatston >or=100); 30%, 98%, 79%, and 87%, respectively (Agatston >or=1,000). Per-patient values for CTCA were 100%, 98%, 97%, and 100%, respectively (p < 0.05). CTCA detected 65% prevalence of all CAD (48% non-obstructive), while CACS detected 37% prevalence of all CAD (21% non-obstructive) (p < 0.05).Conclusion: CACS proved inadequate for the detection of obstructive and non-obstructive CAD compared with CTCA. CTCA has a high diagnostic accuracy for the detection of non-obstructive and obstructive CAD in high-risk asymptomatic patients with inconclusive or unfeasible stress test results.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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