Angiography and Intervention in Asymptomatic Patients with Computed Topography Coronary Artery Calcium Scores Over 400 Whitney J. Goodwin, MD, Mahamadu A. Fuseini, MD, Jonathan D. Norton, Jawahar L. Mehta, MD, Ernest J. Ferris, MD

Purpose: CT is currently being used to screen for coronary artery calcifications. We evaluated the angiographic findings and interventions in patients with calcium scores over 400.

Methods: A total of 3,368 patients (1793 men, 1575 women) were screened using noncontrast 2.5 mm sequential CT slices. Studies were performed with EKG gating on the same four-detector scanner, and the Agatston method was used for scoring. Patients were self-referred, asymptomatic, and ranged in age from 21 to 92 years (54 ±9 years).

Results: 277 (8%) patients had scores over 400. Of these 277 pateints, 69 (25%) underwent coronary angiography. Calcium scores and angiographic findings were evaluated for the left main, left anterior descending, circumflex, and right coronary arteries. Of the 69 patients who underwent an angiogram, 58 (84%) had a greater-than-50% stenosis in at least one coronary artery. Of these 58 patients, 44 had angioplasty, stent placement, and/or coronary artery bypass grafting surgery. The t-tests showed no significant association between calcium scores in specific arteries and angiographic results in those arteries.

Conclusion: 25% of asymptomatic patients with high coronary artery calcification score identified by CT underwent angiography. Of these patients, 84% had positive findings and 64% had an intervention. Scores for specific arteries did not predict angiographic findings in those specific arteries.

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