07 Jan Calcium Score and Coronary CT Offer Additive Prognostic Values in Coronary Artery Disease
MedicalResearch.com Interview with:
Dr. Kongkiat Chaikriangkrai MD
Department of Medicine, Houston Methodist Hospital
Houston, TX 77030
Medical Research: What is the background for this study?
Dr. Chaikriangkrai: Coronary computed tomography angiography (CCTA) and coronary artery calcium score are well known to be useful tools for patients suspected for coronary artery disease. Although both imaging studies are similar in many ways (e.g. CT-based studies, anatomical evaluation of coronary artery disease, etc.), they are completely independent tests that measure different aspects of coronary artery. Furthermore, each test also requires its own separate scan.
In earlier times, calcium score testing was routinely performed prior to CCTA since high calcium score can affect diagnostic accuracy of CCTA. Therefore, CCTA may not be the best option for patients who are known to have high calcium score and other tests along the line can be further considered. However; there have been debates over the need for calcium score scan in this setting alone without enough evidence of additive prognostic benefit of measuring calcium score on top of CCTA due to concerns of extra radiation exposure from performing CT scanning twice.
From this very clinical question, our study was designed to examine whether there was any additional benefit of measuring calcium score over CCTA alone (i.e. Does a patient with high calcium score have worse prognosis than a patient with lower calcium score given that both have similar CCTA results?)
Medical Research: What are the main findings?
Dr. Chaikriangkrai: Our study found that both CCTA and calcium score testing carried its own prognostic value which was independent from each other. Furthermore, measuring calcium score also gave extra ability to predict bad clinical outcomes on top of the information obtained from CCTA alone in patients suspected for coronary artery disease (i.e. A patient with high calcium score did have worse prognosis than a patient with lower calcium score given that both have similar CCTA results).
Medical Research: What should clinicians and patients take away from your report?
Dr. Chaikriangkrai: In patients suspected for coronary artery disease, measuring calcium score in addition to performing CCTA may provide extra diagnostic and prognostic benefit at the cost of slightly higher radiation exposure. However; more research is needed before this approach can be recommended as a standard strategy.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Chaikriangkrai: Multi-center larger-scale prospective studies in this field are much needed to confirm the findings of our study. They should also focus on long-term clinical outcomes and impacts of performing calcium score test and CCTA on clinical decision-making in this patient population.
Additive Prognostic Value of Coronary Artery Calcium Score over Coronary Computed Tomographic Angiography Stenosis Assessment in Symptomatic Patients without Known Coronary Artery Disease et al
Kongkiat Chaikriangkrai, MD
The American Journal of Cardiology, 01/07/2015