Prevalence and Significance of Obstructive Coronary Artery Disease in Patients with Zero Coronary Artery Calcium Score

被引：0
作者：
Akram K. [1 ]
Mehra S. [2 ]
机构：
[1] Department of Internal Medicine, Division of Cardiology, University of Nebraska Medical Center, Omaha, NE, 68198
[2] Department of Hospitalist Medicine, University of Nebraska Medical Center, Omaha, NE
来源：
Current Cardiovascular Imaging Reports | 2010年 / 3卷 / 6期
关键词：
Coronary tomography angiography; Obstructive coronary artery disease; Symptom status; Zero coronary artery calcium score;
D O I：
10.1007/s12410-010-9046-4
中图分类号：
学科分类号：
摘要：
Abundant data have established coronary artery calcium score (CACS) in the algorithm of cardiovascular risk stratification, especially for those at intermediate risk of coronary artery disease (CAD). Absence of CACS is associated with a very low cardiac event rate in asymptomatic individuals and no further imaging is required. Cardiac event rates in symptomatic patients are comparatively higher but still relatively low and have to be interpreted in the context of the population included. Conflicting results from angiography literature with a reported presence of obstructive CAD in up to 39% of mostly symptomatic patients with zero CACS are explained by the higher-risk patients enrolled. CACS is an excellent test for asymptomatic patients in predicting cardiac events and absence of obstructive CAD but has a limited role in symptomatic and higher-risk patients encountered by a cardiovascular specialist, particularly those referred for CT angiography and invasive coronary angiography. This is especially true for relatively young patients (<45 years of age). © 2010 Springer Science+Business Media, LLC.
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页码：350 / 354
页数：4
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  • [1] World Health Report 2002, (2010)
  • [2] Fuster V., Badimon L., Badimon J.J., Chesebro J.H., The pathogenesis of coronary artery disease and the acute coronary syndromes, N Engl J Med, 326, pp. 310-318, (1992)
  • [3] Zheng Z.J., Croft J.B., Giles W.H., Mensah G.A., Sudden cardiac death in the United States, 1989 to 1998, Circulation, 104, pp. 2158-2163, (2001)
  • [4] Chambless L.E., Heiss G., Folsom A.R., Et al., Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993, Am J Epidemiol, 146, pp. 483-494, (1997)
  • [5] Kablak-Ziembicka A., Tracz W., Przewlocki T., Et al., Association of increased carotid intima-media thickness with the extent of coronary artery disease, Heart, 90, pp. 1286-1290, (2004)
  • [6] Agatston A.S., Janowitz W.R., Hildner F.J., Et al., Quantification of coronary artery calcium using ultrafast computed tomography, J Am Coll Cardiol, 15, pp. 827-832, (1990)
  • [7] Janowitz W.R., Agatston A.S., Kaplan G., Viamonte Jr. M., Differences in prevalence and extent of coronary artery calcium detected by ultrafast computed tomography in asymptomatic men and women, Am J Cardiol, 72, pp. 247-254, (1993)
  • [8] Budoff M.J., Georgiou D., Brody A., Et al., Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: a multicenter study, Circulation, 93, pp. 898-904, (1996)
  • [9] Fallavollita J.A., Brody A.S., Bunnell I.L., Et al., Fast computed tomography detection of coronary calcification in the diagnosis of coronary artery disease. Comparison with angiography in patients < 50 years old, Circulation, 89, pp. 285-290, (1994)
  • [10] Haberl R., Becker A., Leber A., Et al., Correlation of coronary calcification and angiographically documented stenoses in patients with suspected coronary artery disease: results of 1, 764 patients, J Am Coll Cardiol, 37, pp. 451-457, (2001)
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