Thread by @CardioOBDoc

✅ Do we have enough evidence to use #CAC zero in pts with stable angina?

✅ What about pts with new Dx of #HF? What’s probability of ischemic cardiomyopathy (obs #CAD) with #CAC zero?

@Heart_SCCT @khurramn1 @MichaelJBlaha @RonBlankstein @lesleejshaw
bit.ly/2IscVbS

@AChoiHeart @DrRumberger @FiRSTSCCT @MarcDweck @joshmitchellmd @SuhnyAbbara @jameschilee @jeffreygeske @arnavkumar @Fentanes_MD @ErinMichos @HeartOTXHeartMD @gina_lundberg @purviparwani @onco_cardiology @RBP0612 @mdmiedema @DrRyanPDaly @mmamas1973 @DrMarthaGulati
@ghoshhajra

Let’s discuss this @Open_HeartBMJ paper
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✅ 1753 pts with suspected stable angina, no known CAD, from a hospital in UK (2009-2016)

✅ CCTA in 751 pts (52%) with #CAC zero showed
▪️89.7% normal coronaries
▪️8.4% stenosis <50%
▪️1.9% stenosis >50%
bit.ly/2IscVbS

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✅ NPV of #CAC zero for excluding stenosis >50% = 98.1%

✅ Previous studies in symptomatic pts with #CAC zero:
1️⃣ Multi-center large CONFIRM registry showed 3.5% stenosis >50%
2️⃣ Single-center study of 1100 pts showed 4.3% stenosis >50%

@khurramn1
bit.ly/2IscVbS

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✅ Absolute annualized rate of MACE (cardiac death, MI, revascularization) for #CAC zero = 1.9 per 1000 person-yrs

✅ NPV of #CAC zero reported in literature = 96% to 99.5% comparable to CCTA & other stress imagining tests

✅ #CAC 🆚 CCTA in symptomatic pts???👇
@khurramn1