Trial reportMayo Clinic proceedings2010
Computed tomographic coronary artery calcium assessment for evaluating chest pain in the emergency department: long-term outcome of a prospective blind study.
Trial report in Mayo Clinic proceedings, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 49 citations in OpenAlex.
- Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives.Journal of cardiovascular development and disease · 2025Review
- Age and the power of zero CAC in cardiac risk assessment: overview of the literature and a cautionary case.The British journal of cardiology · 2022Review
- Review
- Observational
- Zero Calcium Score as a Filter for Further Testing in Patients Admitted to the Coronary Care Unit with Chest Pain.Arquivos brasileiros de cardiologia · 2017Article
- Prognostic value of coronary artery calcium score in patients with stable angina pectoris after percutaneous coronary intervention.Journal of geriatric cardiology : JGC · 2014Article
- The Effectiveness of Calcium Scoring Alongside Coronary Computed Tomography Angiography in Patients with Low-Likelihood of Chest Pain.Iranian journal of public health · 2013Article
- Coronary Artery Calcium Testing in Symptomatic Patients: An Issue of Diagnostic Efficiency.Current cardiovascular imaging reports · 2013Article
- What is the role of calcium scoring in the age of coronary computed tomographic angiography?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2012Review
- Non-ST-segment elevation acute coronary syndromes: targeted imaging to refine upstream risk stratification.Circulation. Cardiovascular imaging · 2012Review
- Coronary CT and the coronary calcium score, the future of ED risk stratification?Current cardiology reviews · 2012Review
- Impact of 64-slice coronary CT on the management of patients presenting with acute chest pain: results of a prospective two-centre study.European radiology · 2012Article
- Immediate computed tomography coronary angiography versus delayed outpatient stress testing for detecting coronary artery disease in emergency department patients with chest pain.The international journal of cardiovascular imaging · 2012Article
- Emergency department assessment of acute-onset chest pain: contemporary approaches and their consequences.Mayo Clinic proceedings · 2010Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the long-term outcome of computed tomographic (CT) quantification of coronary artery calcium (CAC) used as a triage tool for patients presenting with chest pain to an emergency department (ED). PATIENTS AND
methodsPatients (men aged 30-62 years and women aged 30-65 years) with chest pain and low-to-moderate probability of coronary artery disease underwent both conventional ED chest pain evaluation and CT CAC assessment prospectively. Patients' physicians were blinded to the CAC results. The results of the conventional evaluation were compared with CAC findings on CT, and the long-term outcome in patients undergoing CT CAC assessment was established. Primary end points (acute coronary syndrome, death, fatal or nonfatal non-ST-segment elevation myocardial infarction, fatal or nonfatal ST-segment elevation myocardial infarction) and secondary outcomes (coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, coronary stenting, or a combination thereof) were obtained when the patient was dismissed from the ED or hospital and then at 30 days, 1 year, and 5 years.
resultsOf the 263 study patients, 133 (51%) had a CAC score of zero. This absence of CAC correlated strongly with the likelihood of noncardiac chest pain. Among 133 patients with a CAC score of zero, only 1 (<1%) had cardiac chest pain. Conversely, of the 31 patients shown to have cardiac chest pain, 30 (97%) had evidence of CAC on CT. When a CAC cutoff score of 36 was used, as suggested by receiver operating characteristic analysis, sensitivity was 90%; specificity, 85%; positive predictive value, 44%; and negative predictive value, 99%. During long-term follow-up, patients without CAC experienced no cardiac events at 30 days, 1 year, and 5 years.
conclusionFindings suggest that CT CAC assessment is a powerful adjunct in chest pain evaluation for the population at low-to-intermediate risk. Absent or minimal CAC in this population makes cardiac chest pain extremely unlikely. The absence of CAC suggests an excellent long-term (5-year) prognosis, with no primary or secondary cardiac outcomes occurring in study patients at 5-year follow-up.
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