Key result
CAC scores below 133 exclude severe CAD with ~95% NPV.
Why the study?
While the CAC score is established for cardiovascular risk assessment, its precise role in predicting obstructive CAD in symptomatic patients remains debated.
Does coronary artery calcium (CAC) scoring accurately predict obstructive coronary artery disease in symptomatic adults over 40 without prior CAD?
Population
498 symptomatic adults (>40 years) without prior CAD
Comparison
CAC scoring via CT compared to coronary angiography
Design
Prospective analytical diagnostic study
Authors
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Supports CAC to noninvasively rule out severe CAD in symptomatic adults over 40; extends validation beyond asymptomatic screening.
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.
Dindari et al. (2026) studied this question. 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.