The proper use of coronary calcium score and coronary computed tomography angiography for screening asymptomatic patients with cardiovascular risk factors

Shee Yen Tay, Po Yen Chang, Wilson T. Lao, Ying Chin Lin, Yi Han Chung, Wing P. Chan

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Abstract

Early detection and treatment of coronary artery disease (CAD) can reduce incidences of acute myocardial infarction. In this study, we determined the proper use of contributing risk factors and coronary artery calcium score (CACS) when screening asymptomatic patients with coronary arterial stenoses using coronary computed tomography angiography (CCTA). We reviewed 934 consecutive patients who received CACS and CCTA between December 2013 and November 2016. At least one cardiovascular disease risk factor was present in each of the 509 asymptomatic participants. Patients were grouped based on CACS into "zero," "minimal" (0 < CACS ≤ 10), "mild" (10 < CACS ≤ 100), "moderate" (100 < CACS ≤ 400), and "excessive" (CACS > 400). Males over 45 years old with diabetes mellitus and hypertension had a higher risk of significant coronary stenosis. In multivariate analysis, age, sex, hypertension, and diabetes mellitus remained significant predictors of stenosis. A CACS of zero occurred in 227 patients (44.6%). There were no significant differences between the "zero" and "minimal" groups (p = 0.421), but the "mild," "moderate," and "excessive" groups showed correlations with significant coronary stenosis. Age, sex, diabetes mellitus, and hypertension were associated with higher risk of significant coronary stenosis. Asymptomatic patients with CACSs of zero do not require CCTA, and thereby avoid unnecessary radiation exposure.

Original languageEnglish
Article number17653
JournalScientific Reports
Volume7
Issue number1
DOIs
Publication statusPublished - Dec 1 2017

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Coronary Stenosis
Calcium
Coronary Vessels
Diabetes Mellitus
Hypertension
Coronary Artery Disease
Pathologic Constriction
Cardiovascular Diseases
Multivariate Analysis
Myocardial Infarction
Computed Tomography Angiography
Incidence
Therapeutics

ASJC Scopus subject areas

  • General

Cite this

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abstract = "Early detection and treatment of coronary artery disease (CAD) can reduce incidences of acute myocardial infarction. In this study, we determined the proper use of contributing risk factors and coronary artery calcium score (CACS) when screening asymptomatic patients with coronary arterial stenoses using coronary computed tomography angiography (CCTA). We reviewed 934 consecutive patients who received CACS and CCTA between December 2013 and November 2016. At least one cardiovascular disease risk factor was present in each of the 509 asymptomatic participants. Patients were grouped based on CACS into {"}zero,{"} {"}minimal{"} (0 < CACS ≤ 10), {"}mild{"} (10 < CACS ≤ 100), {"}moderate{"} (100 < CACS ≤ 400), and {"}excessive{"} (CACS > 400). Males over 45 years old with diabetes mellitus and hypertension had a higher risk of significant coronary stenosis. In multivariate analysis, age, sex, hypertension, and diabetes mellitus remained significant predictors of stenosis. A CACS of zero occurred in 227 patients (44.6{\%}). There were no significant differences between the {"}zero{"} and {"}minimal{"} groups (p = 0.421), but the {"}mild,{"} {"}moderate,{"} and {"}excessive{"} groups showed correlations with significant coronary stenosis. Age, sex, diabetes mellitus, and hypertension were associated with higher risk of significant coronary stenosis. Asymptomatic patients with CACSs of zero do not require CCTA, and thereby avoid unnecessary radiation exposure.",
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AU - Chang, Po Yen

AU - Lao, Wilson T.

AU - Lin, Ying Chin

AU - Chung, Yi Han

AU - Chan, Wing P.

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