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Coronary artery calcium score and CT angiography in asymptomatic elderly patients with high pretest probability for coronary artery disease

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Abstract

Purpose

To evaluate the role of coronary artery calcium scoring (CACS) and/or coronary CT angiography (CCTA) in asymptomatic elderly patients with high pretest probability for coronary artery disease (CAD).

Materials and methods

Forty-eight consecutive asymptomatic elderly (>65 years) subjects who had a high pretest probability and underwent CACS/CCTA were included. Each CCTA was evaluated for adequacy for assessment of coronary stenosis. Significant stenosis (>50 % diameter narrowing) was assessed on evaluable CT images and by invasive catheter angiography (ICA).

Results

All subjects were men with mean CACS of 880 ± 1779. Among those with low (0–99), intermediate (100–399), and high (400–999) CACS, ICA-verified significant stenosis was present in 8 % (1/13), 23 % (2/13), and 67 % (8/12), respectively. Among those with very high CACS (≥1000) (n = 10), 90 % of CCTAs were not evaluable for stenosis.

Conclusion

In asymptomatic elderly subjects with high pretest probability, CACS followed by CCTA may be considered for those with intermediate to high CACS.

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Abbreviations

CACS:

Coronary artery calcium scoring

CTA:

Computed tomography angiography

CAD:

Coronary artery disease

CCTA:

Coronary computed tomography angiography

DCS:

Duke clinical score

ICA:

Invasive catheter angiography

SD:

Standard deviation

DFM:

Diamond and Forrester method

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Author information

Authors and Affiliations

  1. Applied Imaging Science Laboratory, Department of Radiology, Brigham and Womenʼs Hospital & Harvard Medical School, Boston, MA, USA

    Amir Imanzadeh, Elizabeth George, Frank J. Rybicki & Kanako K. Kumamaru

  2. Department of Cardiology, Takase Clinic, Takasaki, Japan

    Takeshi Kondo & Shinichi Takase

  3. Department of Radiology, Takase Clinic, Takasaki, Japan

    Makoto Amanuma

  4. Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada

    Frank J. Rybicki

  5. Department of Radiology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Kanako K. Kumamaru

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  1. Amir Imanzadeh
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  2. Elizabeth George
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  3. Takeshi Kondo
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Correspondence to Kanako K. Kumamaru.

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Conflict of interest

Dr. Frank J. Rybicki has a research agreement with Toshiba Medical Systems Corporation that is unrelated to this project. No conflict of interest for all other authors.

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Imanzadeh, A., George, E., Kondo, T. et al. Coronary artery calcium score and CT angiography in asymptomatic elderly patients with high pretest probability for coronary artery disease. Jpn J Radiol 34, 140–147 (2016). https://doi.org/10.1007/s11604-015-0506-2

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  • DOI: https://doi.org/10.1007/s11604-015-0506-2

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