A meta-analysis finds a coronary artery calcium score of zero to be highly sensitive for ruling out cardiac events in acute chest pain patients, but does not address its utility within a chest pain pathway.
The coronary artery calcium score (CACS) is a measure of coronary artery disease that has been studied as a predictor of adverse cardiac events, mostly in asymptomatic patients. Only a few studies have evaluated its accuracy in emergency department patients with acute chest pain. Investigators conducted a meta-analysis of such studies.
The analysis included eight studies involving 3556 chest pain patients with nonischemic electrocardiogram (ECG) findings and normal troponin levels. Median follow-up was 10.5 months. Of all enrolled patients, 60% had a CACS of zero. In this group, 0.83% per year had major adverse cardiovascular events (MACE), versus 14.6% in those with a score greater than zero, for a relative risk of 0.06. Of patients with MA…
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DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals