CT coronary artery calcium (CAC) scoring may help determine whether patients with symptoms of heart disease are at low risk of heart attack or stroke, according to research published March 5. . Radiology.

The study results may help patients with stable chest pain avoid invasive coronary angiography (ICA), said lead author Mark Dewey, MD, of the Charité University of Berlin in Germany, as published by RSNA. said in a statement.

”[Our] “Study results 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 very low. “We’re doing it,” Dewey said.

CT-based CAC scoring is a non-invasive method to measure the amount of calcium in cardiac arteries, noted a team led by fellow Charité doctoral candidate Federico Biavatti, MD. A score of 1 to 399 suggests a moderate amount of plaque, and a score of 400 or higher suggests a heavy plaque burden. Conversely, the absence of CAC tends to be a reliable indicator of the absence of advanced atherosclerosis.

However, the role of CAC in patients with stable chest pain remains unclear, explained Biavati et al. To address this knowledge gap, the research group used data from an imaging strategy for patients with stable chest pain and intermediate coronary risk to evaluate 1,749 primary cardiac patients with low CAC scores. We conducted a study to investigate the prognostic value of CAC score for vascular adverse events. Arterial Disease (DISCHARGE) Study.

The study participant had stable chest pain and was referred to the ICA. They were divided into low-, intermediate-, and high-risk categories based on their CAC score and followed for an average of 3.5 years for major adverse cardiovascular events.

The researchers discovered that:

• The 755 participants with a CAC score of 0 had a 0.5% risk rate for a major cardiovascular event.
• The 743 participants with CAC scores between 1 and 399 had 14 major cardiovascular events, giving a risk rate of 1.9%.
• Among the 251 participants with a CAC score of 400 or higher, 17 major cardiovascular events occurred, giving a risk rate of 6.8%.

The research team also reported that the prevalence of obstructive coronary artery disease (CAD) on CT angiography increased from 4.1% in the CAC score 0 group to 76.1% in the CAC score 400 or higher group.

(A, C, E) Examples of axial non-contrast CT scans in participants with a coronary artery calcium (CAC) score of 0, no signs of coronary artery disease on CT, and no major adverse cardiovascular events (B, D, F) Participants with obstructive coronary artery disease who had a CAC score of 1013 on CT (CAC score ≥400 group) and required revascularization. Referring to the left scan, calcified plaques (ovals) are visible in the left main artery and left anterior descending artery (proximal and intermediate segments, B) and in the right scan of the right coronary artery (proximal vessel segment, D; center). You can see it. Vascular segment, F). Image provided by: Radiology.