The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain

Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to p...
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Autor*in:	Rafael Hitter [verfasserIn] Amir Orlev [verfasserIn] Itshak Amsalem [verfasserIn] Nir Levi [verfasserIn] Talya Wolak [verfasserIn] Rivka Farkash [verfasserIn] Naama Bogot [verfasserIn] Michael Glikson [verfasserIn] Arik Wolak [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	coronary CT angiography calcium score chest pain

Übergeordnetes Werk:	In: Journal of Cardiovascular Development and Disease - MDPI AG, 2014, 9(2022), 11, p 390
Übergeordnetes Werk:	volume:9 ; year:2022 ; number:11, p 390

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/jcdd9110390

Katalog-ID:	DOAJ08579628X

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520			\|a Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. The findings suggest that the CACS could impact the management of patients during the scan.
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allfields	10.3390/jcdd9110390 doi (DE-627)DOAJ08579628X (DE-599)DOAJbe84c610912d44cdbfa943fb6ee01894 DE-627 ger DE-627 rakwb eng RC666-701 Rafael Hitter verfasserin aut The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. The findings suggest that the CACS could impact the management of patients during the scan. coronary CT angiography calcium score chest pain Diseases of the circulatory (Cardiovascular) system Amir Orlev verfasserin aut Itshak Amsalem verfasserin aut Nir Levi verfasserin aut Talya Wolak verfasserin aut Rivka Farkash verfasserin aut Naama Bogot verfasserin aut Michael Glikson verfasserin aut Arik Wolak verfasserin aut In Journal of Cardiovascular Development and Disease MDPI AG, 2014 9(2022), 11, p 390 (DE-627)790616017 (DE-600)2777082-5 23083425 nnns volume:9 year:2022 number:11, p 390 https://doi.org/10.3390/jcdd9110390 kostenfrei https://doaj.org/article/be84c610912d44cdbfa943fb6ee01894 kostenfrei https://www.mdpi.com/2308-3425/9/11/390 kostenfrei https://doaj.org/toc/2308-3425 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022 11, p 390
spelling	10.3390/jcdd9110390 doi (DE-627)DOAJ08579628X (DE-599)DOAJbe84c610912d44cdbfa943fb6ee01894 DE-627 ger DE-627 rakwb eng RC666-701 Rafael Hitter verfasserin aut The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. The findings suggest that the CACS could impact the management of patients during the scan. coronary CT angiography calcium score chest pain Diseases of the circulatory (Cardiovascular) system Amir Orlev verfasserin aut Itshak Amsalem verfasserin aut Nir Levi verfasserin aut Talya Wolak verfasserin aut Rivka Farkash verfasserin aut Naama Bogot verfasserin aut Michael Glikson verfasserin aut Arik Wolak verfasserin aut In Journal of Cardiovascular Development and Disease MDPI AG, 2014 9(2022), 11, p 390 (DE-627)790616017 (DE-600)2777082-5 23083425 nnns volume:9 year:2022 number:11, p 390 https://doi.org/10.3390/jcdd9110390 kostenfrei https://doaj.org/article/be84c610912d44cdbfa943fb6ee01894 kostenfrei https://www.mdpi.com/2308-3425/9/11/390 kostenfrei https://doaj.org/toc/2308-3425 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022 11, p 390
allfields_unstemmed	10.3390/jcdd9110390 doi (DE-627)DOAJ08579628X (DE-599)DOAJbe84c610912d44cdbfa943fb6ee01894 DE-627 ger DE-627 rakwb eng RC666-701 Rafael Hitter verfasserin aut The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. The findings suggest that the CACS could impact the management of patients during the scan. coronary CT angiography calcium score chest pain Diseases of the circulatory (Cardiovascular) system Amir Orlev verfasserin aut Itshak Amsalem verfasserin aut Nir Levi verfasserin aut Talya Wolak verfasserin aut Rivka Farkash verfasserin aut Naama Bogot verfasserin aut Michael Glikson verfasserin aut Arik Wolak verfasserin aut In Journal of Cardiovascular Development and Disease MDPI AG, 2014 9(2022), 11, p 390 (DE-627)790616017 (DE-600)2777082-5 23083425 nnns volume:9 year:2022 number:11, p 390 https://doi.org/10.3390/jcdd9110390 kostenfrei https://doaj.org/article/be84c610912d44cdbfa943fb6ee01894 kostenfrei https://www.mdpi.com/2308-3425/9/11/390 kostenfrei https://doaj.org/toc/2308-3425 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022 11, p 390
allfieldsGer	10.3390/jcdd9110390 doi (DE-627)DOAJ08579628X (DE-599)DOAJbe84c610912d44cdbfa943fb6ee01894 DE-627 ger DE-627 rakwb eng RC666-701 Rafael Hitter verfasserin aut The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. The findings suggest that the CACS could impact the management of patients during the scan. coronary CT angiography calcium score chest pain Diseases of the circulatory (Cardiovascular) system Amir Orlev verfasserin aut Itshak Amsalem verfasserin aut Nir Levi verfasserin aut Talya Wolak verfasserin aut Rivka Farkash verfasserin aut Naama Bogot verfasserin aut Michael Glikson verfasserin aut Arik Wolak verfasserin aut In Journal of Cardiovascular Development and Disease MDPI AG, 2014 9(2022), 11, p 390 (DE-627)790616017 (DE-600)2777082-5 23083425 nnns volume:9 year:2022 number:11, p 390 https://doi.org/10.3390/jcdd9110390 kostenfrei https://doaj.org/article/be84c610912d44cdbfa943fb6ee01894 kostenfrei https://www.mdpi.com/2308-3425/9/11/390 kostenfrei https://doaj.org/toc/2308-3425 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022 11, p 390
allfieldsSound	10.3390/jcdd9110390 doi (DE-627)DOAJ08579628X (DE-599)DOAJbe84c610912d44cdbfa943fb6ee01894 DE-627 ger DE-627 rakwb eng RC666-701 Rafael Hitter verfasserin aut The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. The findings suggest that the CACS could impact the management of patients during the scan. coronary CT angiography calcium score chest pain Diseases of the circulatory (Cardiovascular) system Amir Orlev verfasserin aut Itshak Amsalem verfasserin aut Nir Levi verfasserin aut Talya Wolak verfasserin aut Rivka Farkash verfasserin aut Naama Bogot verfasserin aut Michael Glikson verfasserin aut Arik Wolak verfasserin aut In Journal of Cardiovascular Development and Disease MDPI AG, 2014 9(2022), 11, p 390 (DE-627)790616017 (DE-600)2777082-5 23083425 nnns volume:9 year:2022 number:11, p 390 https://doi.org/10.3390/jcdd9110390 kostenfrei https://doaj.org/article/be84c610912d44cdbfa943fb6ee01894 kostenfrei https://www.mdpi.com/2308-3425/9/11/390 kostenfrei https://doaj.org/toc/2308-3425 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022 11, p 390
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For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. 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callnumber-first	R - Medicine
author	Rafael Hitter
spellingShingle	Rafael Hitter misc RC666-701 misc coronary CT angiography misc calcium score misc chest pain misc Diseases of the circulatory (Cardiovascular) system The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain
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topic_title	RC666-701 The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain coronary CT angiography calcium score chest pain
topic	misc RC666-701 misc coronary CT angiography misc calcium score misc chest pain misc Diseases of the circulatory (Cardiovascular) system
topic_unstemmed	misc RC666-701 misc coronary CT angiography misc calcium score misc chest pain misc Diseases of the circulatory (Cardiovascular) system
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title	The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain
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title_full	The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain
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author_browse	Rafael Hitter Amir Orlev Itshak Amsalem Nir Levi Talya Wolak Rivka Farkash Naama Bogot Michael Glikson Arik Wolak
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title_sort	added value of a high ct coronary artery calcium score in the management of patients presenting with acute chest pain vs. stable chest pain
callnumber	RC666-701
title_auth	The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain
abstract	Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. The findings suggest that the CACS could impact the management of patients during the scan.
abstractGer	Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. The findings suggest that the CACS could impact the management of patients during the scan.
abstract_unstemmed	Background: Contrast computerized tomography (CT) scan is occasionally aborted due to a high coronary artery calcium score (CACS). For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. The findings suggest that the CACS could impact the management of patients during the scan.
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container_issue	11, p 390
title_short	The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain
url	https://doi.org/10.3390/jcdd9110390 https://doaj.org/article/be84c610912d44cdbfa943fb6ee01894 https://www.mdpi.com/2308-3425/9/11/390 https://doaj.org/toc/2308-3425
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author2	Amir Orlev Itshak Amsalem Nir Levi Talya Wolak Rivka Farkash Naama Bogot Michael Glikson Arik Wolak
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up_date	2024-07-03T16:54:20.042Z
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For the same CACS in our clinical practice, we observed a higher occurrence of severe coronary artery disease (CAD) in patients with acute chest pain (ACP) compared to patients with stable chest pain (SCP). Since it is known that ACP differs in many ways from SCP, the aim of this study was to compare the predictive value of a high CACS for the diagnosis of severe CAD between ACP and SCP patients. Methods: This single center observational retrospective study included consecutive patients who underwent cardiac CT for chest pain and were found to have a CACS of <200 Agatston units. Patients were divided into two groups, ACP and SCP. Severe CAD was defined as ≥70% stenosis on coronary CT angiography or invasive coronary angiography. Baseline characteristics and final diagnosis of severe CAD were compared. Results: The cohort included 220 patients, 106 with ACP and 114 with SCP. ACP patients had higher severe CAD rates (60.4% vs. 36.8%; <i<p</i< < 0.001). On multivariate analysis including cardiac risk factors, CACS < 400 au (OR = 2.34 95% CI [1.32–4.15]; <i<p</i< = 0.004) and ACP (OR = 2.54 95% CI [1.45–4.45]; <i<p</i< = 0.001) were independent predictors of severe CAD. The addition of the clinical setting of ACP added significant incremental predictive value for severe stenosis. Conclusion: A high CACS is more associated with severe CAD in patients presenting with ACP than SCP. 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The Added Value of a High CT Coronary Artery Calcium Score in the Management of Patients Presenting with Acute Chest Pain vs. Stable Chest Pain

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