Does a zero coronary artery calcium score rule out obstructive CAD in young adults?
A zero coronary artery calcium score is insufficient to rule out obstructive coronary artery disease in young adults presenting with chest pain and risk factors.
Purpose: Young adults are more likely to have non-calcified coronary plaques. Purpose to assess the predictive value of a zero-coronary artery calcium (CAC) score in young adults and to determine which clinical characteristics are associated with obstructive coronary heart disease. Methods: 6775 patients were prospectively entered a registry. They all had a CAC. Mean age 63 +/- 18 years. 56.2 % males. 3525 patients underwent coronary CT angiography (CCTA). 3250 patients underwent single photon emission tomography (SPECT). SPECT patients were mainly outpatients. CCTA patients also were almost exclusively outpatients. Thus, the population was generally a low-risk population. Results: < 0.001). Conclusions: A zero CAC does not rule out significant CAD in young adults with chest pain with CAD risk factors. These patients may need further investigations.
Smettei et al. (Mon,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: