Netherlands Heart Journal

, Volume 19, Issue 5, pp 223–228

Diagnostic and prognostic value of absence of coronary artery calcification in patients with stable chest symptoms

  • D. Rijlaarsdam-Hermsen
  • D. Kuijpers
  • P. R. M. van Dijkman
Original Article

DOI: 10.1007/s12471-011-0097-1

Cite this article as:
Rijlaarsdam-Hermsen, D., Kuijpers, D. & van Dijkman, P.R.M. Neth Heart J (2011) 19: 223. doi:10.1007/s12471-011-0097-1

Abstract

The aim of this study was to determine the prognostic value of a coronary artery calcium score (CACS) of 0 in patients with stable chest symptoms and to compare it as a first-line test with bicycle exercise testing (X-ECG). Altogether, 315 consecutive patients over 44 years of age, with stable chest symptoms and no previous diagnosis of coronary artery disease (CAD) visited the outpatient clinic of our community hospital and underwent both CACS and X-ECG. The mean age was 60.54 years (SD 9.7; range 45–88 years). Of these patients, 141 had no detectable coronary calcium (44.8%) We excluded patients who did not sign informed consent (n = 4). Three patients were lost to follow-up. The follow-up group therefore consisted of 134 patients. The mean follow-up period was 44.6 months (25th–75th percentile: 35.5–54.3 months), during which no major adverse cardiac events (MACE) occurred. The negative predictive value (NPV) was 100%. X-ECG was negative in only 89 patients, equivocal in 39 patients and false-positive in 6 patients requiring additional stress myocardial imaging in 45 patients. NPV as a first-line test was therefore 66.4%. In conclusion: patients over 44 years with stable chest symptoms and no detectable coronary calcium have an excellent prognosis. CACS performs better compared with X-ECG as an initial test in patients with stable chest symptoms.

Keywords

Coronary atherosclerosis Stable coronary artery disease Calcium score Exercise testing 

Copyright information

© Springer Media / Bohn Stafleu van Loghum 2011

Authors and Affiliations

  • D. Rijlaarsdam-Hermsen
    • 1
  • D. Kuijpers
    • 2
  • P. R. M. van Dijkman
    • 1
  1. 1.Department of CardiologyBronovo HospitalThe Haguethe Netherlands
  2. 2.Department of RadiologyBronovo HospitalThe Haguethe Netherlands

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