Correlation of coronary calcification and angiographically documented stenoses in patients with suspected coronary artery disease: Results of 1,764 patients

Objectives This study correlated the electron beam computed tomographic (EB CT) calcium scores with the results of coronary angiography in symptomatic patients in order to assess its value to predict or exclude significant cor onary artery disease (CAD). Background Electron beam computed tomography is a sensitive method to detec t coronary calcium. However, it is unclear whether it may play a role as a filter before invasive procedures in symptomatic patients. Methods A total of 1,764 patients (1,225 men and 539 women) with suspected CAD from a single center were included in our study. All patients underwent calcium screening with EBCT (C150XP Imatron) and conventional coronary ang iography. Results Fifty-six percent of men and 47% of women revealed significant coro nary stenoses (greater than or equal to 50%). Total exclusion of coronary c alcium (14% of the study group) was associated with an extremely low probab ility of stenosis (<1%). With calcium scores <greater than or equal to>20th , greater than or equal to 100th or greater than or equal to 75th percentil e of age groups, the sensitivity to detect stenoses decreased to 97%, 93% a nd 81%, respectively, in men and to 98%, 82% and 76%, respectively, in wome n. At the same time, the specificity increased up to 77% in men and women. There was a significant difference in coronary calcium between men and wome n in all age groups; however, receiver-operating characteristic curves indi cated that the test can be performed with equal accuracy in all of these su bgroups. Conclusions Calcium screening with EBCT is a highly sensitive and moderatel y specific test to predict stenotic disease. Exclusion of coronary calcium defines a substantial subgroup of patients, albeit symptomatic, with a very low probability of significant stenoses. (C) 2001 by the American College of Cardiology.