A CAC score ≥109 predicts obstructive CAD (≥50% stenosis) with 66.6% sensitivity and 80.1% specificity; a score <133 excludes severe CAD (≥80%) with 95.15% NPV.
Does coronary artery calcium (CAC) scoring accurately predict obstructive coronary artery disease in symptomatic adults over 40 without prior CAD?
CAC scoring demonstrates high negative predictive value for severe coronary stenosis, supporting its use as a non-invasive rule-out tool in symptomatic patients over 40 without known CAD.
Tasa de eventos absoluta: 0% vs 0%
Coronary artery disease (CAD) remains the leading cause of global mortality, with coronary artery calcification (CAC) serving as a marker of atherosclerosis. While the CAC score is a well-established non-invasive tool for cardiovascular risk assessment, its precise role in predicting obstructive CAD in symptomatic patients remains debated. This study evaluates the diagnostic and screening utility of the CAC score in detecting significant CAD. In this prospective analytical study, 498 symptomatic adults (>40 years) without prior CAD underwent CAC scoring via CT, followed by coronary angiography as the reference test (CAD defined as ≥50% stenosis). Receiver operating characteristic (ROC) analysis determined the optimal CAC cut-off for CAD detection. The median CAC score was 55 (IQR: 0–233). Among participants, 29.3% and 31.9% were classified as very low and low risk, respectively, based on CAC. A CAC score ≥ 109 predicted obstructive CAD (≥50% stenosis) with 66.6% sensitivity, 80.1% specificity, 65.5% PPV, and 80.95% NPV. For severe CAD (≥80% stenosis), a CAC ≥133 showed 78.6% sensitivity, 74.2% specificity, 35.12% PPV, and 95.15% NPV. A CAC score of ≥109 effectively identifies significant CAD, while a score < 133 strongly excludes severe stenosis. These findings support CAC scoring as a valuable rule-out tool in symptomatic patients over 40 without known CAD, aiding clinical decision-making. ( ClinicalTrials.gov : NCT06311071 ). • This study evaluates the diagnostic value of Coronary Artery Calcium (CAC) scoring in symptomatic adults over 40 without prior CAD. • A CAC score ≥109 effectively predicts obstructive coronary artery disease (≥50% stenosis) with good sensitivity (66.6%) and specificity (80.1%). • A CAC score <133 strongly excludes severe coronary artery stenosis (≥80%), showing high negative predictive value (95.15%). • Findings support using CAC scoring as a valuable, non-invasive rule-out tool for CAD in symptomatic patients, aiding clinical decision-making.
Dindari et al. (Sun,) reported a other. A CAC score ≥109 predicts obstructive CAD (≥50% stenosis) with 66.6% sensitivity and 80.1% specificity; a score <133 excludes severe CAD (≥80%) with 95.15% NPV.