The role of coronary artery calcification score in clinical practice

598 patients with no history of CAD who underwent EBCT for evaluation of CAD were retrospectively included into the study. Ischemia detection test results (exercise stress test, single photon emission computed tomography or ST segment analysis on 24 hours ECG detection), as well as the results of coronary angiography (CAG) were collected.The mean age of the patients was 55 ± 11 years (57% male). Patients were divided according to CAC scores; group A < 10, B 10 – 99, C 100 – 399 and D ≥ 400 (304, 135, 89 and 70 patients respectively). Ischemia detection tests were performed in 531 (89%) patients; negative ischemia results were found in 362 patients (183 in group A, 87 in B, 58 in C, 34 in D). Eighty-eight percent of the patients in group D underwent CAG despite negative ischemia test results, against 6% in group A, 16% in group B and 29% in group C. A positive ischemia test was found in 74 patients (25 in group A, 17 in B, 16 in C, 16 in D). In group D 88% (N = 14) of the patients with a positive ischemia test were referred for CAG, whereas 38 – 47% in group A-C.Our study showed that patients with a high CAC score are more often referred for CAG. The CAC scores can be used as an aid in daily cardiology practice to determine further decision making.Since coronary artery disease (CAD) is a major cause of mortality in industrialized western countries, its detection before complications arise has substantial clinical relevance.[1,2] CAD is caused by atherosclerosis and its first manifestations can be found as early as in the second decade of life.[3] Atherosclerotic lesions may progress to such an extent that coronary flow is impaired. The ensuing myocardial ischemia is clinically manifested as chest pain.[4] Chest pain is one of the first symptoms of CAD and also a common complain for which patients seek medical care. Most often an exercise stress test (EST) is the investigation of first choice in the evaluation of chest pain patients. A positive stress test outcome ple