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Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
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The Zero Calcium Score Paradox.
Rachad Ghazal1, Danish Bawa1, Adnan Ahmed1
1Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, Kansas, USA.
JACC. Case Reports
|March 11, 2024
Summary
A zero calcium score did not rule out severe coronary artery disease in this angina patient. Noncalcified plaque can cause significant stenosis, limiting the coronary calcium score
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Coronary artery disease (CAD) is a leading cause of mortality.
- Coronary calcium score (CCS) is a widely used tool for cardiovascular risk assessment.
- Noncalcified plaque represents a significant, yet often underestimated, component of atherosclerosis.
Purpose of the Study:
- To present a case of angina with severe coronary stenosis despite a zero calcium score.
- To highlight the limitations of the coronary calcium score in symptomatic patients.
- To emphasize the prognostic importance of noncalcified plaque.
Main Methods:
- Case report of a patient presenting with angina.
- Coronary computed tomography angiography (CCTA) to assess coronary anatomy and plaque burden.
- Evaluation of coronary calcium score in conjunction with plaque characterization.
Main Results:
- The patient exhibited severe coronary stenosis.
- The coronary calcium score was zero, indicating no calcified plaque.
- Noncalcified plaque was identified as the cause of the significant stenosis.
Conclusions:
- A zero coronary calcium score does not exclude severe coronary artery disease.
- Noncalcified plaque can lead to significant coronary stenosis and symptoms.
- The coronary calcium score should not be used as a sole predictive tool in symptomatic individuals.
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