Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease

Abstract

Half the patients with coronary artery disease present with sudden death - or acute infarction as first symptom, making early diagnosis pivotal. Myocardial perfusion scintigraphy is frequently used in the assessment of these patients, but it does not detect the disease without flow restriction, exposes the patient to high levels of radiation and is costly. On the other hand, with less radiological exposure, calcium score is directly correlated to the presence and extension of coronary atherosclerosis, and also to the risk of cardiovascular events. Even though calcium score is a tried-and-true method for stratification of asymptomatic patients, its use is still reduced in this context, since current guidelines are contradictory to its use on symptomatic diseases. The aim of this review is to identify, on patients under investigation for coronary artery disease, the main evidence of the use of calcium score associated with functional evaluation and scintigraphy.

A Pilot Study on the Association between Cardiovascular Risk Factors and Coronary Artery Calcification in a Group of Patients Investigated via Cardiac Computed Tomography in a European Country with High Cardiovascular Risk

“…CAD is a multifactorial disease; therefore, it is more clinically effective to evaluate it simultaneously, considering several risk factors associated with CAD [1]. To date, several studies have established the association of CAC with conventional cardiovascular disease risk factors and have also evaluated risk prediction models, biological markers, and imaging means of CVD screening [1,13,15,20,21]. Patients with more risk factors, for example, three factors compared to zero, one, or two, also had higher CAC scores; moreover, CAC has been reported to be an independent predictor of CAD risk [1,13,15,22].…”

The Tip of The Iceberg: Non-Calcified Coronary Plague and Epicardial Adipose Tissue

“…We would like to thank you for your interest and comments related to our recent article. 1 We believe the great scientific basis referent to coronary calcium quantification clearly demonstrates the importance of this method in the stratification of asymptomatic patients with low to intermediate cardiovascular risk. 2 - 7 …”

“…I have read with great interest the article entitled "Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease" by Siqueira et al., 1 recently published in Arquivos Brasileiros de Cardiologia 2016; 107:367-74. The investigators reported the possibility of removing extensive coronary artery disease (CAD) by means of a zero calcium score, or by indicating the presence of an extensive disease when it is severely increased, which justifies the use of this method in the initial or joint evaluation in asymptomatic patients with suspected CAD and in cardiovascular risk stratification.…”

“…The evaluation of symptomatic low-risk patients, despite suggestive evidence, should be re-evaluated in upcoming guidelines. 1 …”