PMID: 9180117Jun 1, 1997Paper

Electron beam computed tomographic coronary calcium score cutpoints and severity of associated angiographic lumen stenosis

Journal of the American College of Cardiology
J A RumbergerR S Schwartz

Abstract

We sought to determine a range of cutpoints for coronary calcium scores measured by electron beam computed tomography (EBCT) in predicting the likely severity of associated angiographic coronary artery stenoses. EBCT can quantify coronary calcium and allow the estimation of atherosclerotic plaque burden, but use of the calcium score to define lumen narrowing is controversial. A total of 213 patients (mean [+/- SD] age 50 +/- 9 years) underwent coronary angiography and EBCT. Maximal percent diameter stenosis in any artery was paired with total coronary calcium score. Receiver operating characteristic (ROC) curve analysis was done using definitions of "disease" for maximal stenosis from > or = 20% to 100%, and the corresponding score cutpoints were determined for 90% sensitivity, 90% specificity or "optimal" sensitivity and specificity. ROC curve areas ranged from a mean (+/- SE) of 0.91 +/- 0.02 for > or = 20% stenosis to 0.83 +/- 0.03 for 100% stenosis. Optimal calcium score cutpoints consisted of nonoverlapping values ranging from 15 for > or = 20% stenosis to 327 for 100% stenosis, whereas sensitivities and specificities ranged from 78% to 84%, depending on maximal stenosis severity. Calcium score cutpoints for 90% sensitivit...Continue Reading

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