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. 2015:2015:582590.
doi: 10.1155/2015/582590. Epub 2015 Feb 5.

Using coronary artery calcification combined with pretest clinical risk assessment as a means of determining investigation and treatment in patients presenting with chest pain in a rural setting

Baskar Sekar  1 , Mark Payne  1 , Azad Hanna  2 , Abdul Azzu  1 , Martin Pike  3 , Michael Rees  2
Affiliations

Using coronary artery calcification combined with pretest clinical risk assessment as a means of determining investigation and treatment in patients presenting with chest pain in a rural setting

Baskar Sekar et al. Biomed Res Int. 2015.

Abstract

462 patients presenting with chest pain to a rural district general hospital underwent calcium scoring and pretest clinical risk assessment in order to stratify subsequent investigations and treatment was retrospectively reviewed. The patients were followed up for two years and further investigations and outcomes recorded. Of the 206 patients with zero calcium score, 132 patients were immediately discharged from cardiac follow-up with no further investigation on the basis of their calcium score, low pretest risk of coronary artery disease, and no significant incidental findings. After further tests, 267 patients were discharged with no further cardiac therapy, 88 patients were discharged with additional medical therapy, and 19 patients underwent coronary artery by-pass grafting or percutaneous intervention. 164 patients with incidental findings on the chest CT (computed tomography) accompanying calcium scoring were reviewed, of which 88 patients underwent further tests and follow-up for noncardiac causes of chest pain. The correlations between all major risk factors and calcium scores were weak except for a combination of diabetes and hypertension in the male gender (P = 0.012), The use of calcium scoring and pretest risk appeared to reduce the number of unnecessary cardiac investigations in our patients: however, the calcium scoring test produced a high number of incidental findings on the associated CT scans.

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Figures

Figure 1
Figure 1
Distribution of calcium scores in patients with a low pretest risk of coronary disease.
Figure 2
Figure 2
Distribution of calcium scores in patients with a medium pretest risk of coronary disease.
Figure 3
Figure 3
Distribution of calcium scores in patients with a high pretest risk of coronary disease.
See this image and copyright information in PMC

References

    1. NICE. NICE Clinical Guideline 95. 2010. http://www.nice.org.uk/guidance/cg95.
    1. Callaway M. P., Richards P., Goddard P., Rees M. The incidence of coronary artery calcification on standard thoracic CT scans. British Journal of Radiology. 1997;70(834):572–574. doi: 10.1259/bjr.70.834.9227248. - DOI - PubMed
    1. Stillman A. E., Oudkerk M., Ackerman M., et al. Use of multidetector computed tomography for the assessment of acute chest pain: a consensus statement of the North American Society of Cardiac Imaging and the European Society of Cardiac Radiology. European Radiology. 2007;17(8):2196–2207. doi: 10.1007/s00330-007-0677-z. - DOI - PubMed
    1. Flotats A., Knuuti J., Gutberlet M., et al. Hybrid cardiac imaging: SPECT/CT and PET/CT. A joint position statement by the European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC) European Journal of Nuclear Medicine and Molecular Imaging. 2011;38(1):201–212. doi: 10.1007/s00259-010-1586-y. - DOI - PubMed
    1. Oudkerk M., Stillman A. E., Halliburton S. S., et al. Coronary artery calcium screening: current status and recommendations from the European Society of Cardiac Radiology and North American Society for Cardiovascular Imaging. European Radiology. 2008;18(12):2785–2807. doi: 10.1007/s00330-008-1095-6. - DOI - PubMed

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