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Meaning of zero coronary calcium score in symptomatic patients referred for coronary computed tomographic angiography.

 Young Jin Kim  ;  Jin Hur  ;  Hye-Jeong Lee  ;  Hyuk-Jae Chang  ;  Ji Eun Nam  ;  Yoo Jin Hong  ;  Hee Young Kim  ;  Ji Won Lee  ;  Byoung Wook Choi 
 European Heart Journal-Cardiovascular Imaging, Vol.13(9) : 776-785, 2012 
Journal Title
 European Heart Journal-Cardiovascular Imaging 
Issue Date
Adult ; Aged ; Aged, 80 and over ; Calcinosis/diagnostic imaging* ; Cardiac-Gated Imaging Techniques ; Chest Pain/diagnostic imaging* ; Chi-Square Distribution ; Contrast Media ; Coronary Angiography/methods* ; Coronary Artery Disease/diagnostic imaging* ; Female ; Humans ; Iopamidol ; Male ; Middle Aged ; Prevalence ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Tomography, X-Ray Computed/methods*
Coronary CT ; Coronary artery calcium ; Chest pain syndrome ; Prognosis
AIMS: The clinical implication of a zero coronary calcium score (CCS) in patients with chest pain syndrome has been under debate. This study was undertaken to determine the meaning of a CCS of zero in a large sample of symptomatic patients referred for coronary computed tomographic (CT) angiography. METHODS AND RESULTS: We consecutively enrolled 2088 patients (age 58 ± 10 years, 1028 men) who had undergone 64-slice cardiac CT due to chest pain syndrome. A CCS of zero was detected in 1114 patients (471 men and 643 women). Of these 1114 patients, obstructive coronary artery disease (CAD) was found in a total of 48 patients (4.3%); 35 men (7.4%) and 13 women (2.0%). Among the zero CCS patients with obstructive CAD, men had a higher prevalence of both premature CAD (49 vs. 0%) and multivessel disease (20 vs. 8%) than women. During the follow-up period (1033 ± 136 days), early revascularization was done in 25 patients (2.2%, 18 men and 7 women) and there were 14 major adverse cardiac events (1.3%, 8 men and 7 women) among the zero CCS patients. CAD severity was a strong prognostic indicator in the zero CCS patients. CONCLUSION: A CCS of zero cannot be used by itself to exclude obstructive CAD in symptomatic patients referred for coronary CT angiography (CCTA). The prevalence of obstructive CAD and adverse cardiac events are not negligible in symptomatic patients with a CCS of zero, and CAD severity by CCTA is associated with higher rates of adverse cardiac event.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Hee Yeong(김희영)
Nam, Ji Eun(남지은)
Lee, Ji Won(이지원)
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
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