What question did this study set out to answer?

To evaluate the diagnostic value of a coronary artery calcium (CAC) score of 0 for ruling out obstructive coronary artery disease (CAD) across various age groups.

October 27, 2021JAMA CardiologyOpen Access

Association of Age With the Diagnostic Value of Coronary Artery Calcium Score for Ruling Out Coronary Stenosis in Symptomatic Patients

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Why the study?

The diagnostic value of a coronary artery calcium score of 0 to rule out obstructive coronary artery disease and near-term clinical events across different age groups was unclear.

Does a coronary artery calcium (CAC) score of 0 reliably rule out obstructive coronary artery disease across different age groups in symptomatic patients?

Population

23 759 symptomatic patients aged 18 years or older undergoing CTA in Denmark

Comparison

Presence of a CAC score of 0 across age groups

Design

Registry-based cohort study

Follow-up

Median 4.3 years

Authors

MMMartin Bødtker MortensenJohns Hopkins University SGSara GaurAarhus University Hospital AFAttila FrimmerAarhus University Hospital

Discussion

Member takes

Implication

CAC score of 0 is less reliable for ruling out obstructive CAD in younger symptomatic patients; hypothesis-generating for age-specific thresholds.

Key Points

To evaluate the diagnostic value of a coronary artery calcium (CAC) score of 0 for ruling out obstructive coronary artery disease (CAD) across various age groups.
Cohort study utilizing data from the Western Denmark Heart Registry.
Included symptomatic patients aged 18 and older who underwent computed tomography angiography (CTA).
Median follow-up time of 4.3 years with analysis performed from April 5 to July 7, 2021.
Of 23,759 patients, 54% had a CAC score of 0; prevalence of obstructive CAD was low across all age groups.
In patients with obstructive CAD, 14% had a CAC score of 0, with prevalence decreasing significantly with age.
The adjusted diagnostic likelihood ratio for a CAC score of 0 varied from 0.68 in those under 40 to 0.18 in those 70 and older.

Structured PICO

Does a coronary artery calcium (CAC) score of 0 reliably rule out obstructive coronary artery disease across different age groups in symptomatic patients?

Population

23,759 symptomatic patients aged 18 years or older who underwent computed tomography angiography (CTA) for suspected coronary artery disease, median age 58, 55% female, from the Western Denmark Heart Registry.

Intervention

Coronary artery calcium (CAC) score of 0

Outcome

Proportion of individuals with obstructive CAD (≥50% luminal stenosis) who had a CAC score of 0surrogate

A CAC score of 0 is significantly less reliable for ruling out obstructive coronary artery disease in younger symptomatic patients compared to older patients.

Cite This Study

Mortensen et al. (2021) studied this question.

synapsesocial.com/papers/6a07e2be416812afca06e699 https://doi.org/10.1001/jamacardio.2021.4406

Topics

Coronary CT angiography

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Implication

CAC score of 0 is less reliable for ruling out obstructive CAD in younger symptomatic patients; hypothesis-generating for age-specific thresholds.

Association of Age With the Diagnostic Value of Coronary Artery Calcium Score for Ruling Out Coronary Stenosis in Symptomatic Patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Association of Age With the Diagnostic Value of Coronary Artery Calcium Score for Ruling Out Coronary Stenosis in Symptomatic Patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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