Coronary artery calcium testing in low-intermediate risk symptomatic patients with suspected coronary artery disease: An effective gatekeeper to further testing?
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Why the study?
Whether quantification of coronary artery calcium plays a role in assessing symptomatic individuals remains a matter of debate.
Does coronary artery calcium testing safely rule out significant coronary artery disease in low-intermediate risk symptomatic patients?
Population
Low-intermediate risk patients with chest pain
Design
Review
Authors
Discussion
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Implication
CAC scoring may aid ruling out obstructive CAD in low-intermediate risk symptomatic patients; leaves open guideline-endorsed gatekeeper role pending prospective trials.
Key Points
- To review the clinical evidence and guidelines evaluating whether coronary artery calcium scoring can effectively rule out coronary artery disease in low-to-intermediate risk symptomatic patients.
- Appraised clinical evidence examining computed tomography coronary artery calcium quantification in symptomatic cohorts presenting with chest pain.
- Evaluated the diagnostic performance and negative predictive value of a zero calcium score alongside clinical guidelines and current limitations.
- A coronary artery calcium score of zero confers a high negative predictive value, effectively ruling out significant obstructive coronary artery disease in low-to-intermediate risk individuals without high-risk features.
- Coronary artery calcium quantification provides a rapid, non-invasive risk stratification tool that can safely prevent unnecessary downstream diagnostic investigations.
Structured PICO
Does coronary artery calcium testing safely rule out significant coronary artery disease in low-intermediate risk symptomatic patients?
P
Population
Low-intermediate risk symptomatic patients with suspected coronary artery disease (chest pain without known ASCVD, non-ischemic ECG, normal initial troponin)
I
Intervention
Coronary artery calcium (CAC) testing
A CAC score of zero may serve as an effective, low-cost, and low-radiation gatekeeper to safely rule out significant CAD and avoid further testing in low-intermediate risk symptomatic patients.
Cite This Study
Mahmood et al. (2020) studied this question.
Topics
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