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A groundbreaking study published today in Radiology, a journal of the Radiological Society of North America (RSNA), reveals that coronary artery calcium scoring with CT scans can accurately identify symptomatic patients with a very low risk of heart attacks or strokes. The findings hold significant promise for improving patient care and potentially sparing some individuals with stable chest pain from undergoing invasive procedures.
The study, led by Federico Biavati, an M.D./Ph.D. candidate at Charité — Universitätsmedizin Berlin, Germany, demonstrated the effectiveness of coronary artery calcium scoring in assessing plaque buildup in heart arteries. Higher scores indicate a greater plaque burden, which is associated with increased risk of cardiovascular events.
According to Biavati, “Coronary artery calcium is a strong and independent predictor of cardiovascular events. The presence of coronary artery calcification indicates that atherosclerosis may have been present for some time.”
Under the guidance of Marc Dewey, M.D., the team evaluated the prognostic value of coronary artery calcium scoring in 1,749 individuals with stable chest pain. The participants, drawn from the DISCHARGE trial involving 26 centers across 16 European countries, underwent invasive coronary angiography, a standard procedure to visualize heart arteries.
The researchers categorized patients into low-, intermediate-, and high-risk groups based on their coronary artery calcium scores and followed them for an average of 3.5 years. The results were striking: individuals with a coronary artery calcium score of zero had an extremely low risk of major adverse cardiovascular events, suggesting that invasive procedures may not be necessary for this group.
Dr. Dewey emphasized the significance of these findings: “This finding may indicate that a zero coronary artery calcium score can play a larger role in patient management strategies.”
Further analysis revealed that patients with higher coronary artery calcium scores faced an increased risk of cardiovascular events, reinforcing the predictive power of this imaging technique.
Despite the promising results, the researchers emphasized the need for additional studies before coronary artery calcium scoring can be widely used to guide patient care decisions.
This study represents a significant advancement in cardiac imaging and underscores the potential of CT scans to inform clinical management strategies for patients with stable chest pain.
