TY - JOUR
T1 - Coronary Artery Calcium Testing in Patients with Chest Pain
T2 - Alive and Kicking
AU - Harrington, Josephine
AU - Mody, Purav
AU - Blankstein, Ron
AU - Nasir, Khurram
AU - Blaha, Michael J.
AU - Joshi, Parag H.
N1 - Funding Information:
Dr. Blaha reports grants from NIH, grants and other from FDA, grants from AHA, grants from Aetna Foundation, grants and personal fees from Amgen Foundation, personal fees from Sanofi Regeneron, personal fees from Novartis, personal fees from MedImmune, personal fees from Akcea, personal fees from Aralez, personal fees from Ferring, and personal fees from Siemens, outside the submitted work.
Publisher Copyright:
© 2017, Springer Science+Business Media New York.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Purpose of Review: We review the potential role of coronary artery calcium (CAC) scoring in the initial evaluation and risk stratification of patients with low- to moderate-risk, stable and acute, chest pain. Recent Findings: A negative CAC score (CAC = 0) has a negative predictive value of 94–99% in symptomatic patients with a low to moderate pretest probability of coronary artery stenosis. The sensitivity is superior to that of stress testing, and the risks, costs, and need for expertise are less than that of coronary CT angiography. Additionally, patients with CAC = 0 have an extremely low risk of future adverse coronary events with an incidence of only 0.0–0.8%, whereas those with CAC > 0 have significantly higher event rates (2.5–18%). Summary: In low-risk chest pain patients, a negative CAC score can effectively “rule out” an ischemic etiology in patients experiencing chest pain. Higher CAC scores are associated with a proportionately increased risk of coronary artery stenosis and warrant further testing. CAC scoring can serve as an effective gatekeeper for further resource utilization given the high prevalence and excellent sensitivity of CAC = 0.
AB - Purpose of Review: We review the potential role of coronary artery calcium (CAC) scoring in the initial evaluation and risk stratification of patients with low- to moderate-risk, stable and acute, chest pain. Recent Findings: A negative CAC score (CAC = 0) has a negative predictive value of 94–99% in symptomatic patients with a low to moderate pretest probability of coronary artery stenosis. The sensitivity is superior to that of stress testing, and the risks, costs, and need for expertise are less than that of coronary CT angiography. Additionally, patients with CAC = 0 have an extremely low risk of future adverse coronary events with an incidence of only 0.0–0.8%, whereas those with CAC > 0 have significantly higher event rates (2.5–18%). Summary: In low-risk chest pain patients, a negative CAC score can effectively “rule out” an ischemic etiology in patients experiencing chest pain. Higher CAC scores are associated with a proportionately increased risk of coronary artery stenosis and warrant further testing. CAC scoring can serve as an effective gatekeeper for further resource utilization given the high prevalence and excellent sensitivity of CAC = 0.
KW - Acute coronary syndrome (ACS)
KW - Angina
KW - Chest pain
KW - Coronary artery calcium
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U2 - 10.1007/s12170-017-0542-9
DO - 10.1007/s12170-017-0542-9
M3 - Review article
AN - SCOPUS:85018244298
SN - 1932-9520
VL - 11
JO - Current Cardiovascular Risk Reports
JF - Current Cardiovascular Risk Reports
IS - 6
M1 - 18
ER -