Calcium Scoring Improves Clinical Management in Patients With Low Clinical Likelihood of Coronary Artery Disease
An erratum to this article was published (JACC Cardiovasc Imaging, Feb 2024 ↗)
Authors' conclusion
Added to an RF-CL model for obstructive CAD, CACS identifies more patients unlikely to benefit from further testing. The number needed to test with CACS to reclassify patients depends on the pretest RF-CL and is lowest in patients with low (>5% to ≤15%) likelihood of CAD.
Study context
- Population
- Patients referred for cardiac imaging for symptoms suggestive of obstructive coronary artery disease (CAD)validation cohorts n = 9,635
- Participants
- 39,837 patients
- Exposure
- Clinical likelihood (CL) with coronary artery calcium scoring (CACS) vs risk factor-weighted CL
- Outcome
- Reclassification rates and number needed to test with CACS to reclassify patients
Methodological detailsvalidated in 3 independent cohorts
- Validated in 3 independent cohorts
Main finding
As reported in the abstract
Reclassification after including CACS
- Patients down- or upclassified after including CACS
- 15,358 (39%)
- Reclassified to very low CACS-CL, of reclassified patients
- 48%
- Number needed to test to reclassify 1 patient from low RF-CL to very low CACS-CL (consistent across age, sex and cohorts)
- 2.1
Observational data: associations, not effects.
Further findings
Correlation with obstructive CAD prevalence
- CACS-CL correlated better to obstructive CAD prevalence than RF-CL
Original publication
Calcium Scoring Improves Clinical Management in Patients With Low Clinical Likelihood of Coronary Artery Disease. JACC Cardiovasc Imaging. Published 3 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →