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Use of coronary artery calcium (CAC) scanning is increasing. Does this risk-stratification tool actually add prognostic value to exercise myocardial perfusion scintigraphy (MPS) in identifying patients at risk for new, angiographically significant coronary artery disease? To find out, researchers compared 1153 patients who underwent CAC scanning (either electron-beam or multislice CT) plus MPS testing with a referent cohort of 9308 patients who had undergone only MPS testing. Mean follow-up was slightly less than 3 years.
In the CAC+MPS group, the higher the baseline CAC score, the more likely a patient was to have inducible ischemia on MPS testing. However, only 64 patients in this group (5.6%) had inducible ischemia — too few to enable ade…