ArticleEuropean journal of nuclear medicine and molecular imaging2015
Very high coronary artery calcium score with normal myocardial perfusion SPECT imaging is associated with a moderate incidence of severe coronary artery disease.
Article in European journal of nuclear medicine and molecular imaging, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 26 citations in OpenAlex.
- Coronary artery calcium score of zero does not rule out obstructive CAD in young adults.American heart journal plus : cardiology research and practice · 2026Article
- Sex-Specific Coronary Artery Calcium Score Threshold Predictive of Obstructive Coronary Artery Disease.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Predictive value of abnormal coronary computed tomography angiography in patients with Normal single-photon emission computed tomography scan.American heart journal plus : cardiology research and practice · 2026Article
- Automated cardiovascular risk categorization through AI-driven coronary calcium quantification in cardiac PET acquired attenuation correction CT.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Implications of transient ischemic dilatation and impaired left ventricular ejection fraction reserve in patients with normal stress myocardial perfusion imaging and elevated coronary artery calcium.The international journal of cardiovascular imaging · 2022Article
- Normal myocardial perfusion despite a very high coronary calcium score.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Relationship Among Coronary Artery Calcium Score, Myocardial Perfusion SPECT and Risk Stratification of Coronary Artery Disease.Annals of nuclear cardiology · 2022Review
- Use of coronary artery calcium scanning as a triage for invasive coronary angiography.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Transient ischemic dilation: An old but not obsolete marker of extensive coronary artery disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Coronary artery calcium scanning in symptomatic patients: Ready for use as a gatekeeper for further testing?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- Coronary artery calcium score as a gatekeeper in the non-invasive evaluation of suspected coronary artery disease in symptomatic patients.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- One year of nuclear cardiology in Europe.Annals of nuclear medicine · 2016Review
- Assessing oral glucose and intravenous insulin loading protocol inWorld journal of nuclear medicineArticle
- Quantification of myocardial blood flow using PET: Current status, clinical applications, and future directions.Progress in cardiovascular diseasesReview
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11 authors at 1 institution in 1 country.
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Abstract
purposeMyocardial perfusion imaging (MPI) has limitations in the presence of balanced multivessel disease (MVD) and left main (LM) coronary artery disease, occasionally resulting in false-normal results despite the high cardiovascular risk associated with this condition. The purpose of this study was to assess the incidence of severe coronary artery disease (CAD) in the presence of a very high Agatston coronary artery calcium (CAC) score (>1,000) in stable symptomatic patients without known CAD but with normal MPI results.
methodsA total of 2,659 prospectively acquired consecutive patients were referred for MPI and evaluation of CAC score by CT. Of this patient population, 8 % (222/2,659) had ischemia without myocardial infarction (MI) on MPIand 11 % (298/2,659) had abnormal MPI (MI and/or ischemia). On presentation 1 % of the patients (26/2,659) were symptomatic, had a CAC score >1,000 and normal MPI results. The definition of normal MPI was strict and included a normal hemodynamic response without ischemic ECG changes and normal imaging, particularly absence of transient ischemic dilation. All of these 26 patients with a CAC score >1,000 and normal MPI findings underwent cardiac catheterization.
resultsOf these 26 patients, 58 % (15/26) had severe disease (≥70 % stenosis) leading to revascularization. Of this group, 47 % (7/15) underwent percutaneous intervention, and 53 % (8/15) underwent coronary artery bypass grafting. All of these 15 patients had either MVD (14/15) or LM coronary artery disease (1/15), and represented 0.6 % (15/2,659) of all referred patients (95 % CI 0.3 - 0.9 %). The majority, 90 % (8/9), had severe CAD with typical chest pain.
conclusionA very high CAC score (>1,000) with normal MPI in a small subset of symptomatically stable patients was associated with a moderate incidence of severe CAD (95 % CI 37 - 77 %). Larger studies and/or a meta-analysis of small studies are needed to more precisely estimate the incidence of CAD in this population. This study also supports the concept that a normal MPI result in patients with severe CAD may be due to balanced MVD.
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