Usefulness of the echocardiographic calcium score as predictive tool for obstructive coronary artery disease

Abstract

Background: The aim of this study was to evaluate the predictive value of the echocardiographic calcium score (ECS). Methods: Ninety-six patients with coronary angiography indication were enrolled in the study: 20 with non-ST-segment elevation acute coronary syndrome, 15 with chronic angina, 31 with ST-segment elevation acute coronary syndrome and 30 asymptomatic patients. After echocardiography with ECS and correlation with coronary artery disease, patients were classified into 2 groups according to ECS ≤1 or ECS ≥2. Results: Among the total number of patients, 23 patients without lesions had ECS: 0.61 and 73 with lesions had ECS: 2.63. In patients presenting lesions, 16 had single lesion with ECS: 1.68 and 57 multiple lesions with ECS: 2.87. In the 23 patients without lesions, 20 had ECS ≤1 and 3 ECS ≥2, and among the 73 patients with lesions, 13 had ECS ≤1 and 60 ECS ≥2. Thus, ECS ≥2 presented a higher frequency of coronary artery disease vs. ECS ≤1 (p <0.05), with 82.2% sensitivity, 87% specificity, 95.2% positive predictive value and 60.6% negative predictive value. In single vs. multiple lesions, 9 out of 16 patients with single lesion had ECS ≥2 and 51 out of 57 patients with multiple lesions had ECS ≥2, with 89.5% sensitivity and 43.8% specificity to identify multi-vessel disease, and 85% positive predictive value and 53.8% negative predictive value. Conclusions: The ECS would have good positive predictive value to assess coronary artery disease.