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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:105-9 - Vol. 71 Num.02 DOI: 10.1016/j.rec.2017.04.012

Impact of Calcium Score on Agreement Between Multidetector Computed Tomography and Invasive Coronary Angiography

José Alberto de Agustín a,, José Juan Gómez de Diego a, Pedro Marcos-Alberca a, Patricia Mahía a, José Luis Rodrigo a, María Luaces a, Iván Javier Núñez-Gil a, Joaquín Ferreiros b, Ana Bustos b, Beatriz Cabeza b, Miguel Ángel García-Fernández a, Carlos Macaya a, Leopoldo Pérez de Isla a

a Instituto Cardiovascular, Hospital Universitario San Carlos, Madrid, Spain
b Departamento de Radiología, Hospital Universitario San Carlos, Madrid, Spain


Calcium score. Computed tomography. Coronary angiography.


Introduction and objectives

Multidetector computed tomography (MDCT) has been demonstrated as a feasible alternative to invasive coronary angiography (ICA). However, contradictory results have been reported regarding the effect of coronary artery calcium score (CS) on the diagnostic accuracy of MDCT. Our aim was to assess the agreement of MDCT and ICA and to evaluate the influence of CS on this agreement.


We enrolled 266 consecutive patients who underwent evaluation with 64-slice MDCT and ICA. Standard CS software tools were used to calculate the Agatston score. Stenosis was qualitatively classified as mild, moderate, or severe by 1 blinded observer and the results were compared with those of ICA, which was used as the gold standard.


The mean age of the patients was 65.4 ± 11.2 years, and 188 patients (70.3%) were men. A total of 484 segments with coronary stenosis ≥ mild were qualitatively evaluated and quantified with MDCT. Noninvasive measurements were concordant with ICA in 402 stenoses (83.05%; Kappa, 0.684), with no significant differences between vessels and with no statistically significant influence of CS on this agreement (OR, 0.93; 95%CI, 0.76-1.09; P = .21). Multidetector computed tomography had high sensitivity, specificity, positive predictive value, and negative predictive value on a per-segment, per-vessel, and per-patient basis.


Non-ICA using MDCT showed good agreement with ICA in the qualitative quantification coronary stenosis and CS had no significant impact on this agreement.

1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved