Calcium score of coronary artery stratifies the risk of obstructive coronary artery diseases

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Abstract

Background and Aims. Coronary heart disease is a major health problem in Malaysia with high morbidity and mortality. Common primary screening tool of cardiovascular risk stratification is exercise treadmill test (ETT). This communication is to determine the performance of coronary artery calcium score a new method to stratify the presence of obstructive coronary artery disease (CAD) in comparison to traditional ETT in patients having coronary artery diseases. Materials and Methods. Patients between 30 to 60 years old attended the ETT to screen for ischemic heart disease were recruited for Agatston coronary artery calcium score (CACS) of multi-sliced computed tomography (MSCT). Subsequently all patients underwent a full MSCT coronary angiography. The major determinant was the state of CAD whether obstructive (50% stenosis or more) or non-obstructive (less than 50% stenosis). All patients diagnosed with obstructive CAD on MSCT coronary angiogram were subjected to invasive coronary angiogram (ICA) to confirm the findings and planned the need for revascularization. Results. The CACS was 100% sensitivity and 97.5% specificity in detecting obstructive CAD at the optimal cut-off value of 106.5 and above. The positive predictive value (PPV) at CACS ≥ 106 was 71.4% and the negative predictive value (NPV) was consistent at 100%. Compare to ETT, the CACS discriminative value and diagnostic performance was much better (PPV 71.4% vs. 45.5%), respectively. Conclusion. CACS can be a good diagnostic screening tool in patients suspected of CAD, and particularly within the non-diagnostic ETT subgroup with low to moderate cardiovascular risks.

Original languageEnglish
Pages (from-to)391-395
Number of pages5
JournalClinica Terapeutica
Volume164
Issue number5
DOIs
Publication statusPublished - 2013

Fingerprint

Exercise Test
Coronary Artery Disease
Coronary Vessels
Calcium
Angiography
Pathologic Constriction
Tomography
Malaysia
Coronary Angiography
Myocardial Ischemia
Coronary Disease
Morbidity
Sensitivity and Specificity
Mortality
Health

Keywords

  • Angiogram
  • Artery calcium score
  • Coronary artery disease
  • Exercise treadmill test
  • Risk stratification

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{446281bf62e440328db9025e5f40488d,
title = "Calcium score of coronary artery stratifies the risk of obstructive coronary artery diseases",
abstract = "Background and Aims. Coronary heart disease is a major health problem in Malaysia with high morbidity and mortality. Common primary screening tool of cardiovascular risk stratification is exercise treadmill test (ETT). This communication is to determine the performance of coronary artery calcium score a new method to stratify the presence of obstructive coronary artery disease (CAD) in comparison to traditional ETT in patients having coronary artery diseases. Materials and Methods. Patients between 30 to 60 years old attended the ETT to screen for ischemic heart disease were recruited for Agatston coronary artery calcium score (CACS) of multi-sliced computed tomography (MSCT). Subsequently all patients underwent a full MSCT coronary angiography. The major determinant was the state of CAD whether obstructive (50{\%} stenosis or more) or non-obstructive (less than 50{\%} stenosis). All patients diagnosed with obstructive CAD on MSCT coronary angiogram were subjected to invasive coronary angiogram (ICA) to confirm the findings and planned the need for revascularization. Results. The CACS was 100{\%} sensitivity and 97.5{\%} specificity in detecting obstructive CAD at the optimal cut-off value of 106.5 and above. The positive predictive value (PPV) at CACS ≥ 106 was 71.4{\%} and the negative predictive value (NPV) was consistent at 100{\%}. Compare to ETT, the CACS discriminative value and diagnostic performance was much better (PPV 71.4{\%} vs. 45.5{\%}), respectively. Conclusion. CACS can be a good diagnostic screening tool in patients suspected of CAD, and particularly within the non-diagnostic ETT subgroup with low to moderate cardiovascular risks.",
keywords = "Angiogram, Artery calcium score, Coronary artery disease, Exercise treadmill test, Risk stratification",
author = "O. Ibrahim and Oteh Maskon and Anwar, {I. R.} and {Che Hassan}, {Hamat Hamdi} and Choor, {Chee Ken} and {Abdul Hamid}, Hamzaini and Rahman, {Md. Mostafizur}",
year = "2013",
doi = "10.7417/CT.2013.1601",
language = "English",
volume = "164",
pages = "391--395",
journal = "Clinica Terapeutica",
issn = "0009-9074",
publisher = "Societa Editrice Universo",
number = "5",

}

TY - JOUR

T1 - Calcium score of coronary artery stratifies the risk of obstructive coronary artery diseases

AU - Ibrahim, O.

AU - Maskon, Oteh

AU - Anwar, I. R.

AU - Che Hassan, Hamat Hamdi

AU - Choor, Chee Ken

AU - Abdul Hamid, Hamzaini

AU - Rahman, Md. Mostafizur

PY - 2013

Y1 - 2013

N2 - Background and Aims. Coronary heart disease is a major health problem in Malaysia with high morbidity and mortality. Common primary screening tool of cardiovascular risk stratification is exercise treadmill test (ETT). This communication is to determine the performance of coronary artery calcium score a new method to stratify the presence of obstructive coronary artery disease (CAD) in comparison to traditional ETT in patients having coronary artery diseases. Materials and Methods. Patients between 30 to 60 years old attended the ETT to screen for ischemic heart disease were recruited for Agatston coronary artery calcium score (CACS) of multi-sliced computed tomography (MSCT). Subsequently all patients underwent a full MSCT coronary angiography. The major determinant was the state of CAD whether obstructive (50% stenosis or more) or non-obstructive (less than 50% stenosis). All patients diagnosed with obstructive CAD on MSCT coronary angiogram were subjected to invasive coronary angiogram (ICA) to confirm the findings and planned the need for revascularization. Results. The CACS was 100% sensitivity and 97.5% specificity in detecting obstructive CAD at the optimal cut-off value of 106.5 and above. The positive predictive value (PPV) at CACS ≥ 106 was 71.4% and the negative predictive value (NPV) was consistent at 100%. Compare to ETT, the CACS discriminative value and diagnostic performance was much better (PPV 71.4% vs. 45.5%), respectively. Conclusion. CACS can be a good diagnostic screening tool in patients suspected of CAD, and particularly within the non-diagnostic ETT subgroup with low to moderate cardiovascular risks.

AB - Background and Aims. Coronary heart disease is a major health problem in Malaysia with high morbidity and mortality. Common primary screening tool of cardiovascular risk stratification is exercise treadmill test (ETT). This communication is to determine the performance of coronary artery calcium score a new method to stratify the presence of obstructive coronary artery disease (CAD) in comparison to traditional ETT in patients having coronary artery diseases. Materials and Methods. Patients between 30 to 60 years old attended the ETT to screen for ischemic heart disease were recruited for Agatston coronary artery calcium score (CACS) of multi-sliced computed tomography (MSCT). Subsequently all patients underwent a full MSCT coronary angiography. The major determinant was the state of CAD whether obstructive (50% stenosis or more) or non-obstructive (less than 50% stenosis). All patients diagnosed with obstructive CAD on MSCT coronary angiogram were subjected to invasive coronary angiogram (ICA) to confirm the findings and planned the need for revascularization. Results. The CACS was 100% sensitivity and 97.5% specificity in detecting obstructive CAD at the optimal cut-off value of 106.5 and above. The positive predictive value (PPV) at CACS ≥ 106 was 71.4% and the negative predictive value (NPV) was consistent at 100%. Compare to ETT, the CACS discriminative value and diagnostic performance was much better (PPV 71.4% vs. 45.5%), respectively. Conclusion. CACS can be a good diagnostic screening tool in patients suspected of CAD, and particularly within the non-diagnostic ETT subgroup with low to moderate cardiovascular risks.

KW - Angiogram

KW - Artery calcium score

KW - Coronary artery disease

KW - Exercise treadmill test

KW - Risk stratification

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U2 - 10.7417/CT.2013.1601

DO - 10.7417/CT.2013.1601

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EP - 395

JO - Clinica Terapeutica

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SN - 0009-9074

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