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CT Coronary Calcification: What Does a Score of “0” Mean?

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Abstract

Calcium score (CS) is a useful tool in evaluating the risk of cardiovascular events in asymptomatic patients. The absence of detectable calcification determines excellent cardiovascular prognosis, with event rates lower than that of negative stress studies, probably due to the latter’s inability to detect nonobstructive coronary artery disease (CAD). There are few primary prevention medications that would be cost-effective in such a low-risk patient population. The interval for retesting patients with zero CS is still open for debate but it should not be in less than 4 to 5 years. CS should not be used to rule out obstructive CAD in symptomatic patients, as its correlation with coronary stenosis is poor and obstructive CAD is commonly found among symptomatic zero CS patients. Most studies have found very low specificity values for CS to detect obstructive CAD in symptomatic patients, meaning it has limited ability to detect the true negative cases (ie, zero CS without obstructive CAD).

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Disclosure

Conflicts of interest: I. Gottlieb: none; L. Sara: none; J.A. Brinker: none; J.A.C. Lima: receives grant support from the National Institutes of Health (Bethesda, MD), the D.W. Reynolds Foundation, and Toshiba Medical Systems (Otawara, Japan); C.E. Rochitte: none.

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Authors and Affiliations

  1. CDPI-Clinica de Diagnósticos por Imagem, Rio de Janeiro, Brazil

    Ilan Gottlieb

  2. UFRJ, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Ilan Gottlieb

  3. CDI—Centro de Diagnóstico por Imagem, Goiânia-Goiás, Brazil

    Leonardo Sara

  4. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jeff A. Brinker & João A. C. Lima

  5. Heart Institute, InCor, University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44, São Paulo, 05403-000, Brazil

    Carlos Eduardo Rochitte

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  1. Ilan Gottlieb
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  2. Leonardo Sara
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  5. Carlos Eduardo Rochitte
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Correspondence to Carlos Eduardo Rochitte.

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Gottlieb, I., Sara, L., Brinker, J.A. et al. CT Coronary Calcification: What Does a Score of “0” Mean?. Curr Cardiol Rep 13, 49–56 (2011). https://doi.org/10.1007/s11886-010-0151-4

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