European Radiology

, Volume 20, Issue 1, pp 81–87 | Cite as

Diagnostic accuracy of computed tomography coronary angiography in patients with a zero calcium score

  • Filippo Cademartiri
  • Erica Maffei
  • Alessandro Palumbo
  • Chiara Martini
  • Sara Seitun
  • Carlo Tedeschi
  • Roberto De Rosa
  • Teresa Arcadi
  • Ignazio Salamone
  • Alfredo Blandino
  • Annick C. Weustink
  • Nico R. Mollet
  • Pim J. De Feyter
  • Gabriel P. Krestin
Cardiac

Abstract

To evaluate the diagnostic accuracy of 64-slice CT coronary angiography (CT-CA) for the detection of significant coronary artery stenosis in patients with zero on the Agatston Calcium Score (CACS). We enrolled 279 consecutive patients (96 male, mean age 48 ± 12 years) with suspected coronary artery disease. Patients were symptomatic (n = 208) or asymptomatic (n = 71), and underwent conventional coronary angiography (CAG). For CT-CA we administered an IV bolus of 100 ml of iodinated contrast material. CT-CA was compared to CAG using a threshold for significant stenosis of ≥50%. The prevalence of disease demonstrated at CAG was 15% (1.4% in asymptomatic). The population at CAG showed no or non-significant disease in 85% (238/279), single vessel disease in 9% (25/279), and multi-vessel disease in 6% (16/279). Sensitivity, specificity, and positive and negative predictive values of CT-CA vs. CAG on the patient level were 100%, 95%, 76%, and 100% in the overall population and 100%, 100%, 100%, and 100% in asymptomatic patients, respectively. CT-CA proves high diagnostic performance in patients with or without symptoms and with zero CACS. The prevalence of significant disease detected by CT-CA was not negligible in asymptomatic patients. The role of CT-CA in asymptomatic patients remains uncertain.

Keywords

Multidetector computed tomography Conventional coronary angiography Coronary artery disease Calcium score Asymptomatic 

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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Filippo Cademartiri
    • 1
    • 2
    • 5
  • Erica Maffei
    • 1
  • Alessandro Palumbo
    • 1
    • 2
  • Chiara Martini
    • 1
    • 2
  • Sara Seitun
    • 1
  • Carlo Tedeschi
    • 3
  • Roberto De Rosa
    • 3
  • Teresa Arcadi
    • 4
  • Ignazio Salamone
    • 4
  • Alfredo Blandino
    • 4
  • Annick C. Weustink
    • 2
  • Nico R. Mollet
    • 2
  • Pim J. De Feyter
    • 2
  • Gabriel P. Krestin
    • 2
  1. 1.Department of Radiology and CardiologyAzienda Ospedaliero-Universitaria di ParmaParmaItaly
  2. 2.Department of Radiology and CardiologyErasmus Medical CenterRotterdamThe Netherlands
  3. 3.Department of Radiology and CardiologyOspedale San GennaroNapoliItaly
  4. 4.Department of RadiologyUniversity HospitalMessinaItaly
  5. 5.Department of RadiologyAzienda Ospedaliero-Universitaria—ParmaParmaItaly

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