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dc.contributor.authorMittal, Tarun K
dc.contributor.authorPottle, Alison
dc.contributor.authorNicol, Ed
dc.contributor.authorBarbir, Mahmoud
dc.contributor.authorAriff, Ben
dc.contributor.authorMirsadraee, Saeed
dc.contributor.authorDubowitz, Michael
dc.contributor.authorGorog, Diana A
dc.contributor.authorClifford, Piers
dc.contributor.authorFiroozan, Soroosh
dc.contributor.authorSmith, Robert
dc.contributor.authorDubrey, Simon
dc.contributor.authorChana, Harmeet
dc.contributor.authorShah, Jaymin
dc.contributor.authorStephens, Nigel
dc.contributor.authorTravill, Christopher
dc.contributor.authorKelion, Andrew
dc.contributor.authorPakkal, Mini
dc.contributor.authorTimmis, Adam
dc.date.accessioned2019-05-10T14:04:47Z
dc.date.available2019-05-10T14:04:47Z
dc.date.issued2017-08-01
dc.identifier.citationMittal , T K , Pottle , A , Nicol , E , Barbir , M , Ariff , B , Mirsadraee , S , Dubowitz , M , Gorog , D A , Clifford , P , Firoozan , S , Smith , R , Dubrey , S , Chana , H , Shah , J , Stephens , N , Travill , C , Kelion , A , Pakkal , M & Timmis , A 2017 , ' Prevalence of obstructive coronary artery disease and prognosis in patients with stable symptoms and a zero-coronary calcium score ' , European heart journal cardiovascular Imaging , vol. 18 , no. 8 , pp. 922-929 . https://doi.org/10.1093/ehjci/jex037
dc.identifier.issn2047-2404
dc.identifier.otherPURE: 13239609
dc.identifier.otherPURE UUID: 61ccc566-5787-4fd4-a555-bd985db44eef
dc.identifier.otherPubMed: 28379388
dc.identifier.otherScopus: 85037717689
dc.identifier.urihttp://hdl.handle.net/2299/21321
dc.description© The Author 2017. Published by Oxford University Press on behalf of the European Society of Cardiology.
dc.description.abstractAims: CT calcium scoring (CTCS) and CT cardiac angiography (CTCA) are widely used in patients with stable chest pain to exclude significant coronary artery disease (CAD). We aimed to resolve uncertainty about the prevalence of obstructive coronary artery disease and long-term outcomes in patients with a zero-calcium score (ZCS). Methods and results: Consecutive patients with stable cardiac symptoms referred for CTCS or CTCS and CTCA from chest pain clinics to a tertiary cardiothoracic centre were prospectively enrolled. In those with a ZCS, the prevalence of obstructive CAD on CTCA was determined. A follow-up for all-cause mortality was obtained from the NHS tracer service. A total of 3914 patients underwent CTCS of whom 2730 (69.7%) also had a CTCA. Half of the patients were men (50.3%) with a mean age of 56.9 years. Among patients who had both procedures, a ZCS was present in 52.2%, with a negative predictive value of 99.5% for excluding ≥70% stenosis on CTCA. During a mean follow-up of 5.2 years, the annual event rate was 0.3% for those with ZCS compared with 1.2% for CS ≥1. The presence of non-calcified atheroma on CTCA in patients with ZCS did not affect the prognostic value (P = 0.98). Conclusion: In patients with stable symptoms and a ZCS, obstructive CAD is rare, and prognosis over the long-term is excellent, regardless of whether non-calcified atheroma is identified. A ZCS could reliably be used as a 'gatekeeper' in this patient cohort, obviating the need for further more expensive tests.en
dc.format.extent8
dc.language.isoeng
dc.relation.ispartofEuropean heart journal cardiovascular Imaging
dc.rightsOpen
dc.subjectJournal Article
dc.titlePrevalence of obstructive coronary artery disease and prognosis in patients with stable symptoms and a zero-coronary calcium scoreen
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Pharmacy, Pharmacology and Postgraduate Medicine
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2017-08-01
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1093/ehjci/jex037
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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