SIGNIFICANT CORONARY ARTERY STENOSIS IN PATIENTS WITH LOW CORONARY ARTERY CALCIUM SCORE

Abstract

Background: Coronary artery disease is a major cause of morbidity and mortality. Non-invasive techniques for diagnosis are becoming increasingly popular and multidetector coronary computed tomography has emerged as a promising modality. Quantifying the amount of coronary artery calcium with unenhanced CT calcium score has been shown to be a reliable noninvasive technique for screening risk of future cardiac events. In previous trials low coronary artery calcium score has been shown to rule out coronary artery disease with high predictive value.

Objective: To evaluate the level of agreement between severity of stenosis on CT angiography and calcium burden as measured by dedicated CT protocols for calcium scoring, comparing their results.

Material and Method: The study was conducted at Radiology Department, Shaukat Khanum Memorial Cancer Hospital and Research Centre and Heart and Body Scan Centre, Lahore. Duration of study was 6 months. The study design was a cross sectional survey.

Results: Mean age of patients was 38.65+5.72. Male to female ratio was 2.5:1 (72 males: 27 females).Agreement of low calcium score and insignificant coronary stenosis was found in 78 patients while 22 showed no agreement. Kappa test was applied, p value was recorded. 0.0005. 50% (11 out of 22) of the patients with calcium score of 0 had significant coronary stenosis.

Conclusion: The results of study reveal that absence of calcium or low calcium does not exclude significant coronary stenosis. Depending on presentation, it is recommended to get calcium score and coronary CT angiography done in the same setting.