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Coronary calcium scoring: are the results comparable to computed tomography coronary angiography for screening coronary artery disease in a South Asian population?

Nizar Bhulani1, Ali Khawaja2*, Asif Jafferani3, Maryam Baqir2, Ramin Ebrahimi4 and Zafar Sajjad5

Author Affiliations

1 Department of Medicine, Research Associate, Aga Khan University, Karachi, Pakistan

2 Medical College, Aga Khan University, Karachi, Pakistan

3 Department of Biological and Biomedical, Sciences, Teaching Assistant, Aga Khan University, Karachi, Pakistan

4 Department of Medicine, Division of Cardiology, University of California Los Angeles, Los Angeles, California, USA

5 Department of Radiology, Associate Professor and Chair, Aga Khan University Hospital, Karachi, Pakistan

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BMC Research Notes 2013, 6:279  doi:10.1186/1756-0500-6-279

Published: 19 July 2013



The need of having feasible screening tools like Coronary Calcium Scoring (CCS) and CT Coronary Artery (CTCA) for Coronary Artery Disease (CAD) has become paramount. We aimed to evaluate the accuracy of CCS in determining the degree of stenosis of coronary vessels as compared to that determined by CTCA in a South Asian population.


A retrospective study was conducted at The Aga Khan University Hospital. A total of 539 patient records were reviewed who had undergone CCS and CTCA between 2008 and 2010. Patient records were reviewed by comparing their CCS and CTCA results.


About 268 out of 301 (89%) patients with a CCS of 0–9 were found to be free of stenosis on CTCA. On a CCS of 10–99, 110 out of 121 (91%) patients were either free of stenosis or had mild stenosis. About 66 out of 79 (84%) patients had moderate or severe stenosis with a calcium score of 100–400 while none of the patients were free of stenosis. Around 28 out of 38 (74%) patients with a CCS of more than 400 had severe stenosis. However, only 04 patients (11%) were found to have mild stenosis. Spearman’s rho revealed a correlation coefficient of 0.791 with a p-value of <0.001.


Our study reaffirms that in South Asian population, low CCS (<100) is associated with no or minimal stenosis while high CCS warrants further investigation; hence, making it a reliable tool for screening patients with CAD.

Coronary calcium scoring; CT Coronary artery; Coronary artery disease; Stenosis; Pakistan; South Asia