Absence of coronary calcification on double-helical CT scans: predictor of angiographically normal coronary arteries in elderly women?

Abstract

To test the hypothesis that angiographically normal coronary arteries in elderly women are identifiable by the absence of coronary calcification on double-helical computed tomographic (CT) scans. Forty-eight consecutive women (age range, 60-76 years) underwent coronary angiography for chest pain evaluation, as well as double-helical CT. Thirty women (mean age, 65 years +/- 5) had coronary artery disease (CAD), defined as any angiographic disease, and 18 women (mean age, 66 years +/- 4) had angiographically normal coronary arteries. Women with angiographically normal coronary arteries had lower coronary calcification scores than those of patients with CAD: 5.7 +/- 11 versus 580 +/- 634, respectively (P = .0004). Seven women with angiographically normal coronary arteries demonstrated mild coronary calcification (score < 50). Of the 11 women without coronary calcification, none had CAD. Thus, the absence of coronary calcification on double-helical CT scans in elderly women was predictive of angiographically normal coronary arteries with 61% sensitivity, 100% specificity, and 85% accuracy. Double-helical CT is an accurate, noninvasive modality for diagnosing angiographically normal coronary arteries in elderly symptomatic women.