Figure 7b.

Potential added value of a CAC score in patients with normal myocardial perfusion who had been referred for evaluation of atypical angina. (a) Stress-rest myocardial perfusion PET images (top) and a representative transverse section from a nonenhanced gated cardiac CT scan (middle) obtained in a 61-year-old man with dyslipidemia and hypertension demonstrate no evidence of coronary artery calcifications (Agatston score = 0 [bottom]). (b) Stress-rest myocardial perfusion PET images (top) and a representative transverse section from a nonenhanced gated cardiac CT scan (middle) obtained in a 59-year-old man with dyslipidemia and a family history of CAD demonstrate coronary artery calcifications that are, however, not extensive (Agatston score = 1348 [bottom]). In both a and b, the normal myocardial perfusion PET scans indicate no evidence of flow-limiting CAD, suggesting an equally low risk in both patients. However, the CAC scores indicate very different degrees of atherosclerosis, suggesting a higher risk in the patient with extensive coronary calcifications. LAD = left anterior descending artery, LCX = left circumflex artery, LM = left main coronary artery, RCA = right coronary artery.