Electron Beam Tomography Quantitation of Coronary Calcium and Assessment for Ischemic Coronary Disease: A Complement to Stress Testing

The 2001 document highlights Electron Beam Tomography (EBT) as a complementary diagnostic tool to stress testing for assessing ischemic coronary disease. EBT, an FDA-approved imaging device, quantifies coronary artery calcified plaque, which correlates with the extent of atherosclerotic disease. The document cites a study with 323 patients where EBT demonstrated an 80% accuracy in predicting significant coronary stenoses, outperforming treadmill exercise testing in some aspects. EBT is particularly useful for patients with equivocal or non-diagnostic stress test results, and when combined with clinical risk profiles, it can identify individuals at high risk for advanced coronary disease. A calcium score of zero indicates a high negative predictive value for obstructive coronary disease, making EBT cost-effective for initial testing in patients with low to intermediate risk of angina. Furthermore, calcium scores from EBT have prognostic value, correlating with the risk of future cardiovascular events. The document concludes that EBT can effectively triage individuals and rule out obstructive disease either as an adjunct to stress testing or as an initial test in certain patients.