OBJECTIVE: We set out to determine whether a coronary artery calcium (CAC) score of zero on computed tomography (CT) would predict a normal myocardial perfusion positron emission tomography (PET) in a population mostly at intermediate pretest likelihood of coronary artery disease (CAD). METHODS: We enrolled 206 outpatients (36% men, mean age 60 ± 13 years) referred for Rb-82 myocardial perfusion PET/CT for suspected CAD. CAC scoring was performed by the Agatston method. The PET images were scored on a 5-point scale using a 17-segment left ventricular model. A summed stress score ≥ 2 was considered abnormal. Multivariable logistic regression analysis was used to test the independent predictive value of a CAC score of zero to exclude inducible myocardial ischemia. RESULTS: Ninety-nine of 206 patients (48%) had a CAC score of zero and of these only 1 had inducible ischemia on PET. This yielded a negative predictive value of 99% (95% CI 95%-100%). CAC score of zero was the strongest independent predictor of a normal myocardial perfusion PET (OR = 0.05; 95% CI = 0.006-0.38; p = 0.004). CONCLUSION: In a population of predominately intermediate likelihood of CAD, a CAC score of zero excludes inducible ischemia on myocardial perfusion PET.
OBJECTIVE: We set out to determine whether a coronary artery calcium (CAC) score of zero on computed tomography (CT) would predict a normal myocardial perfusion positron emission tomography (PET) in a population mostly at intermediate pretest likelihood of coronary artery disease (CAD). METHODS: We enrolled 206 outpatients (36% men, mean age 60 ± 13 years) referred for Rb-82 myocardial perfusion PET/CT for suspected CAD. CAC scoring was performed by the Agatston method. The PET images were scored on a 5-point scale using a 17-segment left ventricular model. A summed stress score ≥ 2 was considered abnormal. Multivariable logistic regression analysis was used to test the independent predictive value of a CAC score of zero to exclude inducible myocardial ischemia. RESULTS: Ninety-nine of 206 patients (48%) had a CAC score of zero and of these only 1 had inducible ischemia on PET. This yielded a negative predictive value of 99% (95% CI 95%-100%). CAC score of zero was the strongest independent predictor of a normal myocardial perfusion PET (OR = 0.05; 95% CI = 0.006-0.38; p = 0.004). CONCLUSION: In a population of predominately intermediate likelihood of CAD, a CAC score of zero excludes inducible ischemia on myocardial perfusion PET.
Authors: Mohamed Mouden; Jan Paul Ottervanger; Jorik R Timmer; Stoffer Reiffers; Ad H J Oostdijk; Siert Knollema; Pieter L Jager Journal: J Nucl Cardiol Date: 2013-12-07 Impact factor: 5.952
Authors: Andor W J M Glaudemans; Riemer H J A Slart; Alessandro Bozzao; Elena Bonanno; Marcello Arca; Rudi A J O Dierckx; Alberto Signore Journal: Eur J Nucl Med Mol Imaging Date: 2010-03-20 Impact factor: 9.236