CT coronary artery calcium (CAC) scoring can identify symptomatic patients at very low risk of heart attack or stroke, according to a new study published in . Radiology. Researchers said this finding may one day help some patients with stable chest pain avoid invasive coronary angiography.

CAC scoring with CT was developed to non-invasively measure the amount of calcium in the arteries of the heart. Higher scores are associated with atherosclerosis. For example, a score of 1 to 399 indicates a moderate amount of plaque, and a score of 400 or higher indicates a high amount of plaque.

“Coronary artery calcium is a strong and independent predictor of cardiovascular events,” says Federico, MD/doctoral candidate in the BIOQIC research training group, radiology resident at Charité University Berlin, and lead author of the study.・Mr. Biavati said. “The presence of coronary artery calcification indicates that atherosclerosis may have been present for some time.”

On the other hand, the complete absence of coronary artery calcification is a good indicator of the absence of advanced atherosclerosis. However, the role of her CAC in patients with stable chest pain is less clear. Stable chest pain is a temporary but recurring symptom caused by stress, exercise, or cold.

Under the direction of Mark Dewey, M.D., professor and associate director of radiology at Charité University, Biavati et al. evaluated the prognostic value of CAC scoring for major adverse cardiovascular events in 1,749 people with an average age of 60 years. evaluated. Participants were selected from the DISCHARGE trial. A research project involving 26 centers in 16 European countries. The participant had stable chest pain and was advised to undergo invasive coronary angiography.

Researchers stratified patients into low-risk, intermediate-risk, and high-risk categories based on CAC scores. They followed participants for an average of 3.5 years and recorded major adverse cardiovascular events.

People with a CAC score of zero were shown to have a very low risk of major adverse cardiovascular events at follow-up. Only 4 of 755 participants (0.5%) in the group had a major adverse cardiovascular event during follow-up. This group also had a lower risk of obstructive coronary artery disease, at only 4.1%.

“This finding may indicate that a coronary calcium score of zero may play a larger role in patient management strategies,” Dr. Dewey said. “The results of this study suggest that patients with stable chest pain and a coronary calcium score of zero may not require invasive coronary angiography using cardiac catheterization because their risk of cardiovascular events is so low. It suggests that there is a sex.”