Diagnostic and prognostic value of absence of coronary artery calcification
Sarwar A et al. – Based on review of >85,000 pts, the absence of coronary artery calcification (CAC) is associated with a very low risk of future cardiovascular events, with modest incremental value of other diagnostic tests in this very low-risk group. Methods- Systematic study of diagnostic and prognostic value of absence of CAC in asymptomatic and symptomatic pts
- Search of online databases for original research articles published in English between January 1990-March 2008 on diagnostic and prognostic utility of CAC
Results- Inclusion criteria fulfilled by 49 studies
- Assessment of relationship of CAC with adverse cardiovascular outcomes in 64,873asymptomatic pts by 13 studies
- In this cohort, 146 of 25,903 pts without CAC (0.56%) had a cardiovascular event during a mean follow-up period of 51 mo
- In 7 studies assessing CAC prognostic value in a symptomatic population, 1.80% of pts without CAC had a cardiovascular event
- Overall, 18 studies showed that presence of any CAC had pooled sensitivity and negative predictive value of 98% and 93%, respectively, for detection of significant coronary artery disease on invasive coronary angiography
- In 4,870 pts undergoing myocardial perfusion and CAC testing, in absence of CAC, only 6% had any sign of ischemia
- In 3 studies, absence of CAC had negative predictive value of 99% for ruling out acute coronary syndrome
[more...]
|
|
|
