Cardiology Medical News about absence of coronary artery disease;diagnostic and prognostic value

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Diagnostic and prognostic value of absence of coronary artery calcification
JACC - Journal of the American College of Cardiology: Cardiovascular Imaging, 06/12/09

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

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