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Does coronary calcium scoring with a SCORE better predict significant coronary artery stenosis than without? Correlation with computed tomography coronary angiography

  • Cardiac
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Abstract

Objective

To determine effectiveness of coronary artery calcium score (CACS) alone and combined with Systematic Coronary Risk Evaluation (SCORE) in adult patients for significant coronary artery stenosis by using computed tomography coronary angiography (CTCA) as reference standard.

Methods

Two thousand twenty-one patients with suspected coronary artery disease (CAD) underwent CACS test and CTCA. Patients were examined with dual-source CT and were grouped according to their age, gender, CACS, and estimated SCORE risk. Coronary plaque existence and degree of stenosis were assessed with CTCA. Sensitivity, specificity, and ROC curves were analyzed.

Results

CACS was the single independent variable in estimating relative risk of critical stenosis and had superior outcome when compared with SCORE risk in logistic regression and ROC curve. Area under the ROC curve was greatest in the interval between 50-59 years. When SCORE was combined with CACS in patients with zero CACS, percentage of significant stenosis increased from 1.4% to 7.0% in patients with high or very high SCORE risk, and decreased to 0.9 % in patients with low or moderate SCORE risk.

Conclusions

CACS combination with SCORE risk predicts coronary artery stenosis. When CACS is zero, CTCA can be performed in patients with high or very high SCORE risk.

Key Points

• CACS is the major predictor of significant stenosis in the sixth and seventh decade.

• CACS has superior outcome when compared with SCORE.

• Zero CACS is the most important negative predictor for significant CAS.

• Zero CACS, with SCORE better predicts significant CAS.

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Abbreviations

CTCA:

Computed tomography coronary angiography

CAD:

Coronary artery disease

CACS:

Coronary artery calcium score

SCORE:

Systematic coronary risk evaluation

CAS:

Coronary artery stenosis

AUC:

Area under the ROC curve

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Acknowledgments

The scientific guarantor of this publication is Deniz Akata MD, Professor. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Prof. Ergun Karaağaoğlu and Jale Karakaya kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was not required for this study because it was a retrospective study. Methodology: retrospective, cross sectional study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Hacettepe University Medical School, Ankara, Turkey

    Gamze Durhan, Tuncay Hazırolan, Muşturay Karçaaltıncaba & Deniz Akata

  2. Department of Cardiology, Hacettepe University Medical School, Ankara, Turkey

    Hamza Sunman & Kudret Aytemir

  3. Department of Biostatistics, Hacettepe University, Ankara, Turkey

    Jale Karakaya & Ergun Karaağaoğlu

Authors
  1. Gamze Durhan
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  2. Tuncay Hazırolan
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  3. Hamza Sunman
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  4. Jale Karakaya
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  6. Kudret Aytemir
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  8. Deniz Akata
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Correspondence to Deniz Akata.

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Durhan, G., Hazırolan, T., Sunman, H. et al. Does coronary calcium scoring with a SCORE better predict significant coronary artery stenosis than without? Correlation with computed tomography coronary angiography. Eur Radiol 25, 776–784 (2015). https://doi.org/10.1007/s00330-014-3477-2

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  • DOI: https://doi.org/10.1007/s00330-014-3477-2

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