Sıfır Kalsiyum Skoru Anlamlı Koroner Arter Darlığını Ekarte Eder mi? : Retrospektif Randomize Kontrollü Çalışma

Abstract

The aim of this study was to determine effectiveness of calcium score (CaS) and systematic coronary risk evaluation (SCORE) in significant coronary artey stenosis using non-invasive coronary computed tomography angiography (CCTA). From 2005 to 2012, 3212 patients who underwent concominant CaS test and CCTA were retrospectively enrolled. Soft plaque existence and stenosis rate of all patients assessed (no stenosis, insignificant <50% and significant ?50 % stenosis at least in one of the arteries were recorded). All patients were grouped according to their age, gender, CaS and SCORE values. CaS were evaluated in six groups zero and intervals between 1-10, 11-100,101-400, 401-1000, and ?1000 respectively. SCORE were evaluated in four groups low, moderate, high and very high risk. CaS and SCORE were important prognostic factors of critical stenosis. İn logistic regression analysis and ROC CaS showed superior outcome classification ability when compared with SCORE risk. 0 CaS was predictive of significant stenosis (%98,6), but when the SCORE value was added to the model, it was a highly significant predictor of outcome. İn this group, if patient have low or moderate SCORE values, NPV increases to %99,1, if not NPV decreases to %93. In conclusion 0 CaS and low-moderate SCORE values excludes obstructive coronary artery disease and eliminates the need for further exposure to radiation by CCTA. However in patients with high or very high values of SCORE, even if CaS 0, CCTA should be continued or futher tests and aggressive management should be applied for significant stenosis.