Using Coronary Artery Calcium Score as Diagnostic Tool in Symptomatic Chronic Coronary Syndrome Patients in a Real-Life Setting
M Patrick Witvliet,1,2 E Karin Arkenbout,3 Pieter W Kamphuisen1,4 1Department of Internal Medicine, Tergooi Medical Center, Hilversum, the Netherlands; 2Department of General Practice, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands; 3Department of Cardiology, Tergooi Medi...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-09-01
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| Series: | Vascular Health and Risk Management |
| Subjects: | |
| Online Access: | https://www.dovepress.com/using-coronary-artery-calcium-score-as-diagnostic-tool-in-symptomatic--peer-reviewed-fulltext-article-VHRM |
| _version_ | 1827824336942137344 |
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| author | Witvliet MP Arkenbout EK Kamphuisen PW |
| author_facet | Witvliet MP Arkenbout EK Kamphuisen PW |
| author_sort | Witvliet MP |
| collection | DOAJ |
| description | M Patrick Witvliet,1,2 E Karin Arkenbout,3 Pieter W Kamphuisen1,4 1Department of Internal Medicine, Tergooi Medical Center, Hilversum, the Netherlands; 2Department of General Practice, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands; 3Department of Cardiology, Tergooi Medical Center, Hilversum, the Netherlands; 4Department of Vascular Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the NetherlandsCorrespondence: M Patrick Witvliet, Department of Internal Medicine, Tergooi Medical Center, Laan van Tergooi 2, 1212 VG, Hilversum, the Netherlands, Tel +31 205664271, Email m.p.witvliet@amsterdamumc.nlBackground: The coronary artery calcium (CAC) score can be used to increase (CAC score > 0) or decrease (CAC score = 0) the likelihood of coronary artery disease (CAD). We compared the CAC score with the pre-test probability (PTP) for CAD (low, intermediate, and high). Furthermore, we compared the CAC score with exercise electrocardiography (ECG) and compared both tests with coronary angiography.Methods and Results: We retrospectively identified patients with angina and/or dyspnea for whom CAC score was used to increase or decrease the likelihood of CAD. Of 882 patients, majority had low (45%) or intermediate (44%) PTP. Patients with higher PTP had significantly higher CAC scores (Cramer’s V = 0.29, p < 0.0001). Most patients (57%) had a CAC score of zero, especially those with low (73%) and intermediate (49%) PTP. However, 20% of patients with high PTP had CAC score of zero. Higher CAC scores were observed in patients with abnormal exercise ECG, but association was weak and not significant (Cramer’s V = 0.13, p = 0.08). Moreover, more than 40% of patients with an abnormal exercise ECG had CAC score of zero. Higher CAC scores were associated with more severe abnormalities on coronary angiography (Cramer’s V = 0.43, p < 0.0001), whereas there was no association between results of exercise ECG and coronary angiography (Cramer’s V = 0.11, p = 0.91).Conclusion: CAC score can be used in addition to PTP to increase or decrease the likelihood of CAD, and it might be more useful than exercise ECG in the diagnostic work-up of chest pain.Keywords: coronary artery disease, cardiovascular disease, CT, risk factors, angina, stable |
| first_indexed | 2024-03-12T02:25:05Z |
| format | Article |
| id | doaj.art-6b4181b227b14eff85561d3aa5ace33c |
| institution | Directory Open Access Journal |
| issn | 1178-2048 |
| language | English |
| last_indexed | 2024-03-12T02:25:05Z |
| publishDate | 2023-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Vascular Health and Risk Management |
| spelling | doaj.art-6b4181b227b14eff85561d3aa5ace33c2023-09-05T19:17:36ZengDove Medical PressVascular Health and Risk Management1178-20482023-09-01Volume 1957158286434Using Coronary Artery Calcium Score as Diagnostic Tool in Symptomatic Chronic Coronary Syndrome Patients in a Real-Life SettingWitvliet MPArkenbout EKKamphuisen PWM Patrick Witvliet,1,2 E Karin Arkenbout,3 Pieter W Kamphuisen1,4 1Department of Internal Medicine, Tergooi Medical Center, Hilversum, the Netherlands; 2Department of General Practice, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands; 3Department of Cardiology, Tergooi Medical Center, Hilversum, the Netherlands; 4Department of Vascular Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the NetherlandsCorrespondence: M Patrick Witvliet, Department of Internal Medicine, Tergooi Medical Center, Laan van Tergooi 2, 1212 VG, Hilversum, the Netherlands, Tel +31 205664271, Email m.p.witvliet@amsterdamumc.nlBackground: The coronary artery calcium (CAC) score can be used to increase (CAC score > 0) or decrease (CAC score = 0) the likelihood of coronary artery disease (CAD). We compared the CAC score with the pre-test probability (PTP) for CAD (low, intermediate, and high). Furthermore, we compared the CAC score with exercise electrocardiography (ECG) and compared both tests with coronary angiography.Methods and Results: We retrospectively identified patients with angina and/or dyspnea for whom CAC score was used to increase or decrease the likelihood of CAD. Of 882 patients, majority had low (45%) or intermediate (44%) PTP. Patients with higher PTP had significantly higher CAC scores (Cramer’s V = 0.29, p < 0.0001). Most patients (57%) had a CAC score of zero, especially those with low (73%) and intermediate (49%) PTP. However, 20% of patients with high PTP had CAC score of zero. Higher CAC scores were observed in patients with abnormal exercise ECG, but association was weak and not significant (Cramer’s V = 0.13, p = 0.08). Moreover, more than 40% of patients with an abnormal exercise ECG had CAC score of zero. Higher CAC scores were associated with more severe abnormalities on coronary angiography (Cramer’s V = 0.43, p < 0.0001), whereas there was no association between results of exercise ECG and coronary angiography (Cramer’s V = 0.11, p = 0.91).Conclusion: CAC score can be used in addition to PTP to increase or decrease the likelihood of CAD, and it might be more useful than exercise ECG in the diagnostic work-up of chest pain.Keywords: coronary artery disease, cardiovascular disease, CT, risk factors, angina, stablehttps://www.dovepress.com/using-coronary-artery-calcium-score-as-diagnostic-tool-in-symptomatic--peer-reviewed-fulltext-article-VHRMcoronary artery diseasecardiovascular diseasectrisk factorsanginastable |
| spellingShingle | Witvliet MP Arkenbout EK Kamphuisen PW Using Coronary Artery Calcium Score as Diagnostic Tool in Symptomatic Chronic Coronary Syndrome Patients in a Real-Life Setting Vascular Health and Risk Management coronary artery disease cardiovascular disease ct risk factors angina stable |
| title | Using Coronary Artery Calcium Score as Diagnostic Tool in Symptomatic Chronic Coronary Syndrome Patients in a Real-Life Setting |
| title_full | Using Coronary Artery Calcium Score as Diagnostic Tool in Symptomatic Chronic Coronary Syndrome Patients in a Real-Life Setting |
| title_fullStr | Using Coronary Artery Calcium Score as Diagnostic Tool in Symptomatic Chronic Coronary Syndrome Patients in a Real-Life Setting |
| title_full_unstemmed | Using Coronary Artery Calcium Score as Diagnostic Tool in Symptomatic Chronic Coronary Syndrome Patients in a Real-Life Setting |
| title_short | Using Coronary Artery Calcium Score as Diagnostic Tool in Symptomatic Chronic Coronary Syndrome Patients in a Real-Life Setting |
| title_sort | using coronary artery calcium score as diagnostic tool in symptomatic chronic coronary syndrome patients in a real life setting |
| topic | coronary artery disease cardiovascular disease ct risk factors angina stable |
| url | https://www.dovepress.com/using-coronary-artery-calcium-score-as-diagnostic-tool-in-symptomatic--peer-reviewed-fulltext-article-VHRM |
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