Coronary artery anomalies in patients with zero calcium score: A new evidence supports the 2016-NICE guidance

Purpose: Coronary artery calcium (CAC) is a specific indicator of and an independent risk factor for atherosclerosis; however, calcium scoring may miss noncalcified plaques, which may have clinical importance. The aim of this study was both to identify the presence and extent of coronary plaques during computed tomography coronary angiography (CTCA) in patients with a zero CAC score and to evaluate the effect of risk factors and symptom status on the presence of noncalcified plaques.Materials and Methods: In this retrospective study, we analyzed the cases of 842 consecutive patients between October 2006 and November 2011. Of these patients, we included 357 with a zero calcium score in the study. Information regarding patient age, sex, coronary risk factors, and symptom status were recorded. Coronary calcium-scoring scans were followed by CTCA. The calcium scores were calculated, and the presence of noncalcified plaques and significant stenoses (>50% of vessel diameter) was evaluated.Results: Of the 357 patients with a zero calcium score, 37 (10.36%) had atherosclerotic plaques; 9 patients (2.52%) had significant coronary stenosis. Among coronary risk factors, only diabetes mellitus was significantly correlated with any risk factors (presence of atherosclerosis and obstructive coronary artery disease; P = .030 and .013, respectively).Conclusion: Although CAC scoring is a safe and a reliable test to exclude obstructive coronary artery disease, the absence of CAC does not definitively exclude the presence of atherosclerosis. CTCA is a more appropriate method for determining the atheroma burden.

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TCT-373 Impact of Epicardial Fat Volume on Coronary Artery Disease in Symptomatic Patients with a Zero Calcium Score

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2012.08.401 ◽

2012 ◽

Vol 60 (17) ◽

pp. B107

Author(s):

Tsuyoshi Ito ◽

Mitsuyasu Terashima ◽

Kenya Nasu ◽

Masashi Kimura ◽

Yoshihisa Kinoshita ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Calcium Score ◽

Epicardial Fat ◽

Epicardial Fat Volume ◽

Artery Disease ◽

Zero Calcium Score ◽

Fat Volume

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Role of Coronary Calcium Score as a Screening Tool for Excluding Significant Coronary Artery Disease in High Risk Asymptomatic Patients

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.9-1.158 ◽

2022 ◽

Vol 9 (1) ◽

pp. 64-68

Author(s):

Fariha Afzal ◽

Muhammad Imran Khan ◽

Zenab

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

High Risk ◽

Screening Tool ◽

Coronary Artery Stenosis ◽

Significant Coronary Artery Disease ◽

Calcium Score ◽

Artery Stenosis ◽

Artery Disease ◽

Zero Calcium Score

OBJECTIVES: To determine correlation of zero coronary artery calcium score (CACS) with non-significant coronary artery stenosis by using computed tomography coronary angiography (CTCA). METHODOLOGY: 62 patients with suspected coronary artery disease (CAD) underwent CACS test and CTCA from April 2018 to November 2020. Patients were examined with 160 slice multidetector CT and grouped according to their age, gender, CACS, and maximum coronary luminal stenosis. CACS was assessed using Agatston scoring and degree of stenosis was assessed by automatic software and severity was scored according to CAD-RADS. The correlation between these two main variables was calculated using Spearman rank correlation. RESULTS: The 62 patients were divided into four groups according to CACS, using the Agatston Unit (AU). Group 1; 0 AU (41 patients, 66.13%), Group 2; 1-100 AU (13 patients, 20.97%) Group 3; 101-400 AU (4 patients, 6.45%), Group 4; 401-1000 AU (4 patients, 6.45%). In 41 patients with zero calcium score (32 males and 9 females), 38 patients (92.68%) were found to have no coronary artery stenosis, 2 patients (4.87%) had mild coronary artery stenosis and 1 patient (2.43%) had moderate coronary artery stenosis. Total 35 patients presented for screening purpose out of which 25 (71%) had zero calcium score and no significant coronary artery disease. CONCLUSION: In high risk patients, zero calcium score excludes significant coronary artery stenosis (50%), hence coronary calcium score is a good screening tool before subjecting patients to coronary angiography.

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