Zero CT Coronary Calcium a 'Gatekeeper' Screen in Acute Chest Pain

"Zero CAC has a very high negative predictive value [and] can be used for a screening test" in low- to intermediate-risk patients with acute chest pain in the ER," Dr Gowtham R Grandhi ( Society of Cardiovascular Computed Tomography (SCCT) 2017 Annual Scientific Meeting. In symptomatic patients with low- to medium-risk of ACS, just over half had a CT CAC of zero, and of these, only 0.7% had obstructive CAD (>50% stenosis).
Editorial comment:

The data in chest pain patients presenting for risk stratification in the Netherlands

Chest pain patients in the ED In Houston

 and the recent study is very clear a low dose non contrast chest CT coronary calcium score of zero is associated with a less than 1% cardiac event rate a one year. Those clinicians with 640 slice CT scanners don't like this data and scream soft plaque. But soft plaques calcify after the age of 40 and for the age group 40 to 65 a CAC of zero is a excellent gatekeeper .

Stephen Stowers MD FACC FRACP

Consultant Cardiologist

MidCentral Health PNH

New Zealand

Cite this article: Zero Coronary Calcium a 'Gatekeeper' Screen in Acute Chest Pain? - Medscape - Aug 07, 2017.

CSANZ 2017 Perth Australia CT Coronary Calcium