Abstract

MENDOZA RODRIGUEZ, Vladimir et al. Usefulness of the calcium score in the diagnosis of obstructive coronary disease. Rev Cubana Invest Bioméd [online]. 2010, vol.29, n.4, pp. 403-416. ISSN 1561-3011.

Introduction: The presence of calcium in coronary arteries is practically pathognomonic of the atherosclerosis. In 1990, Agatston designed a method for to quantify the calcium by tomography. The aim of present paper was to determine the coronary calcium score to confirm or to rule out a significant coronary obstruction. Methods: In present study authors included 276 patients (80 % of male sex and a mean age of 56 ± 10 years) with suspect of ischemic heart disease, who initially underwent a quantification of coronary calcium by 64 scans tomography and then a catheterization coronariography. The sensitivity, specificity, positive and negative predictive value, credibility reasons, Kappa index and diagnostic validity for scan points 0, 25, 50, 100 and 400 Agatston (AU) of calcium score for patients and arteries to diagnose a significant coronary stenosis taking as reference pattern the invasive coronary one, as well as the area under the ROC curve. A p <0,05 and a reliability rate of 95 % were considered as significant. Results: The sensitivity, specificity and negative predictive value were of 96%, 51% and 92,4%, respectively and a Kappa index of 0,46 (95% CI, 0,37-0,56), (p <0,0001) for a scan point 0 UA and for a scan point 50 UA were of 84,%, 80% and 84%, respectively with a Kappa index of 0,64 (95 % CI, 0,56-0,74),(<0,0001). In analysis by patients the area under the ROC curve, the sensitivity, specificity and negative predictive value were of 91%, 66 % and 96 %, respectively with a Kappa index of 0,43 (95 % CI, 0,39-0,48), (p<0,0001) and for the scan point 25 UA 83 % and 94 %, respectively with a Kappa index of 0,58 (95 % CI, 0,52-063), (p<0,0001). Conclusions: The calcium quantification in coronary arteries by 64 scans tomography is a useful tool in stratification of patients with suspect of ischemic heart disease.

Keywords : Coronary calcium; significant coronary stenosis; tomography.

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