Table 2. Significance and Application of “Zero Coronary Artery Calcium Score” .
| Study Authors | Year | Study Cohort | Resultsa |
|---|---|---|---|
| Thompson and Stanford (59) | 2001 | Not Applicable | Exclusion of significant CAD likelihood in CACS=0 |
| Shemesh et al. (58) | 2003 | 50 | Low CACS characterized patients with acute coronary events |
| Knez et al. (60) | 2004 | 2,115 | Very accurate in obstructive CAD exclusion in subjects > 50 years old |
| Church et al. (63) | 2007 | 10,746 | Very low CAD risk in the intermediate term |
| Akram et al. (71) | 2008 | 210 | CACS is better in asymptomatic subjects, especially in patients < 45 years to exclude obstructive CAD |
| Cademartiri et al. (72) | 2010 | 279 | Prevalence of significant CAD was not negligible in asymptomatic patients with CACS=0 |
| Ergun et al. (61) | 2010 | 883 | CACS=0 patients had positive CTA findings, especially when risk factors exist |
| Gottlieb et al. (73) | 2010 | 291 | Frequent occurrence of total coronary occlusion in CACS=0 patients |
| Uretsky et al. (62) | 2011 | 1,119 | CACS=0 is rarely accompanied by hemodynamically significant CAD |
| Esteves et al. (74) | 2011 | 206 | CACS=0 excluded inducible ischemia in an intermediate risk group |
| Sonowski et al. (75) | 2011 | 166 | Relatively low incidence of significant coronary stenosis in CACS=0 patients |
| Alqarqaz et al. (76) | 2011 | 333 | Nearly one in five patients with CACS=0 had non-calcified plaque |
| Villines et al. (77) | 2011 | 5,128 | In symptomatic patients with a CACS=0, obstructive CAD is possible and is associated with increased cardiovascular events |
| Chen et al. (78) | 2012 | 519 | Plaques are present in a significant proportion of individuals with CACS=0 |
| Morita et al. (79) | 2012 | 2,160 | If patients are male and elderly even if CACS=0 the likelihood of vulnerable plaque exists especially in the presence of spotty calcification |
| Kim et al. (80) | 2012 | 1,114 | Prevalence of obstructive CAD and adverse cardiac events are not negligible in symptomatic patients with CACS=0 |
| Meyer et al. (81) | 2012 | 121 | Significant CAD is extremely unlikely in symptomatic Caucasian patients with an intermediate risk score and CACS=0 |
| Büyükterzi et al. (82) | 2013 | 288 | The frequency of non-calcified plaques is too high to be ignored in CACS=0 |
| Cho et al. (83) | 2013 | 4,491 | A future risk of exclusive non-calcified plaque in asymptomatic subjects with CACS=0 was negligible |
| Lee et al. (84) | 2013 | 6,531 | In asymptomatic subjects with CACS=0 presence of non-calcified plaque was associated with cardiac events |
| Mouden et al. (85) | 2013 | 868 | A CACS=0 in stable patients at low or intermediate risk excludes flow-limiting CAD |
aAbbreviations: CAD: Coronary artery disease; CACS: Coronary artery calcium score; CTA: Computed tomography angiograph