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Correlation of coronary calcification and angiographically documented stenoses in patients with suspected coronary artery disease: results of 1,764 patients
Open accessAbstract
Objectives This study correlated the electron beam computed tomographic (EBCT) calcium scores with the results of coronary angiography in symptomatic patients in order to assess its value to predict or exclude significant coronary artery disease (CAD).Background Electron beam computed tomography is a sensitive method to detect coronary calcium. However, it is unclear whether it may play a role as a filter before invasive procedures in symptomatic patients.Methods A total of 1,764 patients (1,225 men and 539 women) with suspected CAD from a single center were included in our study. All patients underwent calcium screening with EBCT (C150XP Imatron) and conventional coronary angiography.Results Fifty-six percent of men and 47% of women revealed significant coronary stenoses (> or =50%). Total exclusion of coronary calcium (14% of the study group) was associated with an extremely low probability of stenosis (<1%). With calcium scores > or =20th, > or =100th or > or =75th percentile of age groups, the sensitivity to detect stenoses decreased to 97%, 93% and 81%, respectively, in men and to 98%, 82% and 76%, respectively, in women. At the same time, the specificity increased up to 77% in men and women. There was a significant difference in coronary calcium between men and women in all age groups; however, receiver-operating characteristic curves indicated that the test can be performed with equal accuracy in all of these subgroups.Conclusions Calcium screening with EBCT is a highly sensitive and moderately specific test to predict stenotic disease. Exclusion of coronary calcium defines a substantial subgroup of patients, albeit symptomatic, with a very low probability of significant stenoses.
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“In contrast, coronary calcium scanning shows a very high negative predictive value: the Agatston score of 0 has a negative predictive value of nearly 100% for ruling out a significant coronary narrowing.154”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [154]
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Metadata
- Authors
- Haberl, R., Becker, A., Leber, A., Knez, A., Becker, C., Lang, C., Brüning, R., Reiser, M., & Steinbeck, G.
- Affiliations
- Ludwig-Maximilians-Universität München (DE)
- Corresponding author
- Haberl, Ralph
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2001-02
- Volume
- 37
- Issue
- 2
- Pages
- 451-457
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1965053385
- Cited by
- 472
- References
- 53
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 7 · 2023: 14 · 2022: 6 · 2021: 11 · 2020: 15 · 2019: 11 · 2018: 14 · 2017: 14 · 2016: 15 · 2015: 24 · 2014: 22 · 2013: 24 · 2012: 26
- FWCI
- 17.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Minnesota
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Artery Anomalies
- Keywords
- coronary artery calcification, electron beam computed tomography, calcium scoring, coronary artery disease, coronary artery stenosis, coronary angiography, diagnostic accuracy, sex differences, symptomatic patients
- MeSH terms
- Adult, Aged, Calcinosis, Coronary Artery Disease, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Risk Factors, ROC Curve, Sex Factors, Tomography, X-Ray Computed, Coronary Angiography
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