Does negative calcium score exclude coronary artery disease

AimWe aimed to measure the coronary calcification and investigate if negative coronary calcification excludes coronary artery disease (CAD).MethodsClinically indicated patients were scanned using 64 slice CCT to measure Agatston coronary calcification score. CT coronary angiography( CTA) was performed, and invasive coronary angiography (CA) was performed when it is indicated.Results2352 patients were scanned. 1152 patients had negative calcium score (49%). The mean age was 52±13.2 y, 65% males, & 35% females. Chest pain was the indication in 80% of cases. There was 37% diabetic, 58% hypertensive, 23.6% hyperlipidemic, 13% smoker, & 32% with family history of CAD.The calcium score excludes CAD in 90% of patients as confirmed by normal coronary CTA. In 10% of patients who had negative calcium, coronary plaques were found by CTA. CA was performed in 50% of those with negative CA score, where 30% had coronary stenting, 20% had bypass surgery , 35% had mild disease, and 15% had non obstructive lesions.ConclusionNegative calcium score excludes CAD in 90% of patients as confirmed by normal CTA. Coronary CTA is an important tool to detect early coronary atherosclerosis even in absence of coronary calcification