A Coronary Artery Calcium Score of Zero in Patients Who Have Undergone Coronary Computed Tomography Angiography Is Associated With Freedom From Major Adverse Cardiovascular Events

Shiga, Yuhei; Morii, Joji; Idemoto, Yoshiaki; Tashiro, Kohei; Yano, Yuiko; Kato, Yuta; Kuwano, Takashi; Sugihara, Makoto; Miura, Shin‐ichiro

doi:10.14740/jocmr4335

Cited by 4 publications

(2 citation statements)

References 14 publications

(31 reference statements)

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“…MACE rates in stable chest pain patients with CCS 0 were reported in 19 studies ( Supplementary Table 3 ). CCS 0 was present in 27–100 % of the included cohorts 12 13 14 15 18 19 28 38 39 40 41 42 43 44 45 46 47 48 . Of the CCS 0 patients, 0–2.1 % suffered from MACE during a follow-up period from 1.6 to 6.8 years 12 13 14 15 18 19 28 38 39 40 41 42 43 45 46 48 .…”

Section: Prognostic Value Of Coronary Calcium Scorementioning

confidence: 99%

“…21 studies reported the event rate of MACE in patients with CCS > 0 ( Supplementary Table 4 ) 12 13 14 15 18 19 28 38 39 40 41 42 43 44 45 46 47 . Event rates ranged from 0.6 % to 34 % during a follow-up of 1 to 6.8 years 12 13 14 15 18 19 21 28 37 38 39 40 42 43 45 46 .…”

Section: Prognostic Value Of Coronary Calcium Scorementioning

confidence: 99%

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The Diagnostic and Prognostic Value of Coronary Calcium Scoring in Stable Chest Pain Patients: A Narrative Review

Koopman

Willemsen

Harst

et al. 2022

Rofo

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Background Non-contrast computed tomography (CT) scanning allows for reliable coronary calcium score (CCS) calculation at a low radiation dose and has been well established as marker to assess the future risk of coronary artery disease (CAD) events in asymptomatic individuals. However, the diagnostic and prognostic value in symptomatic patients remains a matter of debate. This narrative review focuses on the available evidence for CCS in patients with stable chest pain complaints. Method PubMed, Embase, and Web of Science were searched for literature using search terms related to three overarching categories: CT, symptomatic chest pain patients, and coronary calcium. The search resulted in 42 articles fulfilling the inclusion and exclusion criteria: 27 articles (n = 38 137 patients) focused on diagnostic value and 23 articles (n = 44 683 patients) on prognostic value of CCS. Of these, 10 articles (n = 21 208 patients) focused on both the diagnostic and prognostic value of CCS. Results Between 22 and 10 037 patients were included in the studies on the diagnostic and prognostic value of CCS, including 43 % and 51 % patients with CCS 0. The most evidence is available for patients with a low and intermediate pre-test probability (PTP) of CAD. Overall, the prevalence of obstructive CAD (OCAD, defined as a luminal stenosis of ≥ 50 % in any of the coronary arteries) as determined with CT coronary angiography in CCS 0 patients, was 4.4 % (n = 703/16 074) with a range of 0–26 % in individual studies. The event rate for major adverse cardiac events (MACE) ranged from 0 % to 2.1 % during a follow-up of 1.6 to 6.8 years, resulting in a high negative predictive value for MACE between 98 % and 100 % in CCS 0 patients. At increasing CCS, the OCAD probability and MACE risk increased. OCAD was present in 58.3 % (n = 617/1058) of CCS > 400 patients with percentages ranging from 20 % to 94 % and MACE occurred in 16.7 % (n = 175/1048) of these patients with percentages ranging from 6.9 % to 50 %. Conclusion Accumulating evidence shows that OCAD is unlikely and the MACE risk is very low in symptomatic patients with CCS 0, especially in those with low and intermediate PTPs. This suggests a role of CCS as a gatekeeper for additional diagnostic testing. Increasing CCS is related to an increasing probability of OCAD and risk of cardiac events. Additional research is needed to assess the value of CCS in women and patient management in a primary healthcare setting. Key Points: Citation Format

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Section: Prognostic Value Of Coronary Calcium Scorementioning

confidence: 99%

Section: Prognostic Value Of Coronary Calcium Scorementioning

confidence: 99%

The Diagnostic and Prognostic Value of Coronary Calcium Scoring in Stable Chest Pain Patients: A Narrative Review

Koopman

Willemsen

Harst

et al. 2022

Rofo

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Prognosis impact of multiple novel lymphocyte‐based inflammatory indices in patients with initially diagnosed coronary artery disease

Gao,

Bai,

et al. 2024

Immunity Inflam & Disease

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BackgroundThis study aimed to evaluate six novel lymphocyte‐based inflammatory markers (neutrophil‐lymphocyte ratio, monocyte‐lymphocyte ratio, platelet‐lymphocyte ratio [PLR], systemic immune inflammation index [SII], systemic inflammatory response index, and systemic immune inflammation response index [SIIRI]) in patients with newly diagnosed coronary artery disease [CAD].MethodsA total of 959 patients newly diagnosed with CAD and underwent diagnostic coronary angiography were enrolled in this study and followed for major adverse cardiovascular events (MACEs), including cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. The best cutoff value was used to compare the six indicators. Cox risk regression analysis evaluated the relationship between novel lymphocyte‐based inflammatory markers and MACEs in newly diagnosed CAD patients.ResultsDuring a mean follow‐up period of 33.3 ± 9.9 months, 229 (23.9%) MACEs were identified. Multivariate Cox regression analysis showed that only SIIRI (hazard ratio [HR]: 5.853; 95% confidence interval [CI]: 4.092–8.371; p < .001) and PLR (HR: 1.725; 95% CI: 1.214–2.452; p = .002) were independent predictors of MACEs. Nevertheless, following the adjustment for covariates, only the SIIRI was found to be a significant predictor MACEs and its corresponding specific endpoint occurrences. The predictive ability of the model was improved when six different inflammatory markers were added to the basic model established by traditional risk factors, namely, the C‐index increased, and the SIIRI increased most significantly (AUC: 0.778; 95% CI: 0.743–0.812; p < .001). However, among the six novel inflammatory markers, only SIIRI had improved net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI: 0.187; 95% CI: 0.115–0.259, p < .001. IDI: 0.135; 95% CI: 0.111–0.159, p < .001), which was superior to the basic model established by traditional risk factors.ConclusionsSIIRI is independent predictor of MACEs in newly diagnosed CAD patients. SIIRI was superior to other measures in predicting MACEs. The combination of SIIRI and traditional risk factors can more accurately predict MACEs.

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Stepwise cardiovascular risk stratification in patients with type 2 diabetes based on coronary CT assessment

Wada,

Iwanaga,

Nakai

et al. 2025

Journal of Diabetes and its Complications

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A Coronary Artery Calcium Score of Zero in Patients Who Have Undergone Coronary Computed Tomography Angiography Is Associated With Freedom From Major Adverse Cardiovascular Events

Cited by 4 publications

References 14 publications

The Diagnostic and Prognostic Value of Coronary Calcium Scoring in Stable Chest Pain Patients: A Narrative Review

The Diagnostic and Prognostic Value of Coronary Calcium Scoring in Stable Chest Pain Patients: A Narrative Review

Prognosis impact of multiple novel lymphocyte‐based inflammatory indices in patients with initially diagnosed coronary artery disease

Stepwise cardiovascular risk stratification in patients with type 2 diabetes based on coronary CT assessment

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