This article is more than 5 years old. Information may no longer be current.

Coronary artery calcification, TIMI score effectively identify patients at risk for CAD, ACS

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Coronary artery calcification scoring in combination with clinical risk assessment using the TIMI score reliably identified patients at risk for acute coronary syndrome and coronary artery disease, according to data presented at the American College of Cardiology Scientific Session.

When used in combination, the scoring system may be applicable in situatuions where coronary computed tomography angiography is not available and a coronary artery calcification score is known, according to the researchers.

“What we know is that the negative predictive value of coronary artery calcification is very high, but the risk for a future event is not zero,” Daniel O. Bittner, MD, a fellow at Massachusetts General Hospital, told Cardiology Today. “So there is risk for misclassification, and that’s why we sought to determine the predictive value of the combination of coronary artery calcification together with TIMI risk scoring for this acute chest pain population.”

Bittner and colleagues evaluated 826 consecutive patients (mean age, 52.6 years; 41.9% female) who underwent CTA. Of those patients, 53.8% (n=444) had no CAC and 63.4% (n=524) had a TIMI score of 0, while 39.7% (n=328) had both. The negative predictive value of CAC was 99.8% for ≥70% stenosis and 99.5% for ACS.

When combined with the TIMI score, the negative predictive value of TIMI score was 0 and no CAC was 100.0% for ≥70% stenosis and ACS.

The positive predictive value for a combination of presence of any CAC and TIMI score > 0 to predict ACS was 13.1%.

Though not intended to be a replacement for CCTA, prior coronary artery calcification scans can contain valuable information regarding evaluation of patients with acute chest pain.

Bittner said that although the results are positive, the combination should not completely replace CCTA.

“It is not meant to be a substitute for CCTA because we know that CCTA has a very high predictive value and excellent accuracy,” he said. “Also, the additional incremental risk of CCTA beyond that of CAC is very minimal nowadays.” – by Julie Gotchel

Reference:

Bittner Daniel O, et al. Assessing the Patient with Chest Pain. Presented at: American College of Cardiology Scientific Session; April 2-4, 2016; Chicago.

Disclosure: Bittner reports no relevant financial disclosures.