Objectives Using the spiral CT to scan coronary calcification, with qualitative and semi-quantitative method, to predict the presence and extent of coronary artery disease.
Background Early diagnosis of coronary artery disease has been an important clinical issue. Coronary angiography was the gold standard for diagnosis of coronary artery disease, but to have invasive examination, only used in a small fraction of patients. Clinical diagnosis in most patients still need to rely on non-invasive examination. Women have a lower incidence of coronary artery disease, high load test false positive rate. Detection of coronary artery disease in female patients is very important. Coronary artery calcium deposition within the intima is a sign of atherosclerosis. CAC associated with the presence and extent of coronary atherosclerosis.
Methods 108 symptomatic women (mean age 50±5; range 45–76 years) received coronary angiography and chest CT scan. CT image shows left main and at least proximal and middle part of anterior descending was considered acceptable CT scans, punctate calcification as mild, segmental calcification as moderate and diffuse as severe. Stenosis were measured in three vessels. Completely normal coronary artery was defined as no stenosis. Stenosis less than 50% was considered non-obstructive, while more than 50% stenosis as obstructive coronary artery disease.
Results Of all the 108 patients, 41 confirmed by coronary angiography with normal coronary artery, 67 patients in contrast with the narrow, including 12 non-obstructive, 55 of obstructive stenosis. There were no difference in patient with or without obstructive stenosis. 41 patients with normal coronary angiography showed that 26 were not calcified, 15 with mild calcification. The sensitivity to predict obstructive CAD was 68.7%, specificity was 92.8%.
Conclusion Symptomatic women patients without CAC on chest CT scan may have less possibility of obstructive CAD. Such patients may not need excessive coronary angiography.
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