Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Journal of Nuclear Cardiology
Published in: Journal of Nuclear Cardiology 1/2023

10-01-2023 | EDITORIAL

The “power of zero” CAC validated for absence of ischemia on PET?

Authors: Daniel M. Huck, MD, MPH, Brittany Weber, MD, PhD

Published in: Journal of Nuclear Cardiology | Issue 1/2023

Login to get access

Excerpt

In this issue of JNC, Van den Hoogen et al provide further evidence for the “power of zero,” a term for the high negative predictive value (NPV) of a coronary artery calcium (CAC) score of zero for the absence of obstructive coronary artery disease (CAD) and low cardiovascular risk in both asymptomatic and symptomatic patients. They extend the value of zero CAC to the prediction of absent ischemia on PET myocardial perfusion imaging (MPI) in symptomatic patients. Further studies in diverse populations with higher cardiometabolic and inflammatory risk factor burden, including the prognostic value of CAC to predict nonobstructive plaque and coronary microvascular dysfunction, would be important future extensions to this novel work. …
Literature
1.
Arnett DK, Blumenthal RS, Albert MA, et al. ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2019;2019:140.
2.
Di Carli MF, Gupta A. Estimating pre-test probability of coronary artery disease: battle of the scores in an evolving CAD landscape. JACC Cardiovasc Imaging 2019;12:1401‐4.CrossRefPubMed
3.
Winther S, Schmidt SE, Mayrhofer T, et al. Incorporating coronary calcification into pre-test assessment of the likelihood of coronary artery disease. J Am Coll Cardiol 2020;76:2421‐32.CrossRefPubMed
4.
Agha AM, Pacor J, Grandhi GR, et al. The prognostic value of CAC zero among individuals presenting with chest pain: a meta-analysis. JACC Cardiovasc Imaging 2022;15:1745‐57.CrossRefPubMed
5.
Writing Committee M, Gulati M, Levy PD, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2021;78:e187‐285.CrossRef
6.
Danad I, Raijmakers PG, Driessen RS, et al. Comparison of coronary CT angiography, SPECT, PET, and hybrid imaging for diagnosis of ischemic heart disease determined by fractional flow reserve. JAMA Cardiol 2017;2:1100.CrossRefPubMedPubMedCentral
7.
Douglas PS. Comparison of a precision care strategy with usual testing to guide management of stable patients with suspected coronary artery disease. Presented at AHA 2022, Chicago, IL, 2022.
8.
Bavishi C, Argulian E, Chatterjee S, Rozanski A. CACS and the frequency of stress-induced myocardial ischemia during MPI: a meta-analysis. JACC Cardiovasc Imaging 2016;9:580‐9.CrossRefPubMed
9.
Schenker MP, Cho Tek Hong E, Rybicki FJ, Hachamovitch R, Kwong RY, DiCarli MF. Interrelation of coronary calcification, myocardial ischemia, and outcomes in patients with intermediate likelihood of coronary artery disease. Circulation 2008;117:1693‐700.CrossRefPubMedPubMedCentral
10.
Megna R, Nappi C, Gaudieri V, et al. Diagnostic value of clinical risk scores for predicting normal stress myocardial perfusion imaging in subjects without coronary artery calcium. J Nucl Cardiol 2022;29:323‐33.CrossRefPubMed
11.
Ishimori ML, Martin R, Berman DS, et al. Myocardial ischemia in the absence of obstructive coronary artery disease in systemic lupus erythematosus. JACC Cardiovasc Imaging 2011;4:27‐33.CrossRefPubMed
12.
Weber B, Perez-Chada LM, Divakaran S, et al. Coronary microvascular dysfunction in patients with psoriasis. J Nucl Cardiol 2022;29:37‐42.CrossRefPubMed
Metadata
Title
The “power of zero” CAC validated for absence of ischemia on PET?
Authors
Daniel M. Huck, MD, MPH
Brittany Weber, MD, PhD
Publication date
10-01-2023
Publisher
Springer International Publishing
Published in
Journal of Nuclear Cardiology / Issue 1/2023
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-022-03192-1

Other articles of this Issue 1/2023

Journal of Nuclear Cardiology 1/2023 Go to the issue

Review Article

Non-invasive diagnosis of vasospastic angina

Images that Teach

Long-term intense FDG uptake in a non-infected prosthetic aortic heart valve implanted 18 years ago

Original Article

Clinical features and prognosis of isolated cardiac sarcoidosis diagnosed using new guidelines with dedicated FDG PET/CT

Original Article

Quantitative 99mTc-DPD-SPECT/CT assessment of cardiac amyloidosis

WHAT IS THIS IMAGE?

What is this image? 2022 Image 4 result: Massive right ventricular hypertrophy detected by Tc-99m sestamibi SPECT MPI study

Editorial

Embers after fire: Are we close to real time visualization of persistent inflammation post-Kawasaki disease?