Half the patients with coronary artery disease present with sudden death - or
acute infarction as first symptom, making early diagnosis pivotal. Myocardial
perfusion scintigraphy is frequently used in the assessment of these patients,
but it does not detect the disease without flow restriction, exposes the patient
to high levels of radiation and is costly. On the other hand, with less
radiological exposure, calcium score is directly correlated to the presence and
extension of coronary atherosclerosis, and also to the risk of cardiovascular
events. Even though calcium score is a tried-and-true method for stratification
of asymptomatic patients, its use is still reduced in this context, since
current guidelines are contradictory to its use on symptomatic diseases. The aim
of this review is to identify, on patients under investigation for coronary
artery disease, the main evidence of the use of calcium score associated with
functional evaluation and scintigraphy.