Predicting Significant Coronary Obstruction in a Population with Suspected Coronary Disease and Absence of Coronary Calcium: CORE-64 / CORE320 Studies.

Background: Coronary artery calcium (CAC) scanning can be performed using non-contrast computed tomography to predict cardiovascular events, but has less value for risk stratification in symptomatic patients.

Objective: To identify and validate predictors of significant coronary obstruction (SCO) in symptomatic patients without coronary artery calcification.

Methods: A total of 4,258 participants were screened from the CORE64 and CORE320 studies that enrolled patients referred for invasive angiography, and from the Quanta Registry that included patients referred for coronary computed tomography angiography (CTA).

CT coronary calcification: What does a score of "0" mean?

Calcium score (CS) is a useful tool in evaluating the risk of cardiovascular events in asymptomatic patients. The absence of detectable calcification determines excellent cardiovascular prognosis, with event rates lower than that of negative stress studies, probably due to the latter's inability to detect nonobstructive coronary artery disease (CAD). There are few primary prevention medications that would be cost-effective in such a low-risk patient population.

The left main facts: faced, spun, but alas too few.

Bypass surgery has been shown to prolong life in patients with significant left main stenosis compared with medical therapy and is the current standard of care. Recent registry data suggest that stenting may offer intermediate-term results similar to surgery, although with a greater need for repeat revascularization. Drug-eluting stents appear to improve the outcomes of stenting.

Diagnostic accuracy of arterial phase 64-slice multidetector CT angiography for left atrial appendage thrombus in patients undergoing atrial fibrillation ablation.

Introduction: Multidetector CT (MDCT) is used prior to atrial fibrillation ablation (AFA) to anatomically guide ablation procedures. Whether 64-slice MDCT also can be used to diagnose left atrial thrombus is not known.

Methods: We sought to determine the accuracy and interobserver variability of MDCT in the evaluation of left atrial thrombus prior to AFA.