Critical Appraisal of A Clinical Risk Score to Avoid Coronary Computed Tomography in Patients with Calcium Score of Zero

Introduction: Patients with a calcium score of zero have a low but non-negligible probability of obstructive coronary artery disease (CAD). Recently, a clinical score was proposed to identify a subset of patients with a calcium score of zero with very low likelihood of CAD, in whom coronary CT angiography (CCTA) could be safely withheld. The aim of this study was to assess the performance of this tool in a Portuguese cohort of patients undergoing CCTA for suspected CAD.