{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:43:29Z","timestamp":1787499809492,"version":"build-2736575974"},"reference-count":33,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journalofcardiovascularct.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cardiovascular Computed Tomography"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1016\/j.jcct.2026.06.011","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T20:00:45Z","timestamp":1783108845000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Coronary calcium to rule out obstructive coronary artery disease in patients with non-anginal chest pain"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5861-5599","authenticated-orcid":false,"given":"Christoph","family":"Ryffel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6947-8229","authenticated-orcid":false,"given":"Elena A.","family":"Igual","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1102-6217","authenticated-orcid":false,"given":"Raffael","family":"Ghenzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Stuetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2609-6330","authenticated-orcid":false,"given":"Konstantinos","family":"Bitos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7390-633X","authenticated-orcid":false,"given":"Julia","family":"Duelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-3170","authenticated-orcid":false,"given":"Andreas A.","family":"Giannopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8627-726X","authenticated-orcid":false,"given":"Dominik C.","family":"Benz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8847-2154","authenticated-orcid":false,"given":"Aju P.","family":"Pazhenkottil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Gr\u00e4ni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-5210","authenticated-orcid":false,"given":"Philipp A.","family":"Kaufmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8064-8904","authenticated-orcid":false,"given":"Ronny R.","family":"Buechel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jcct.2026.06.011_bib1","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.124.017567","article-title":"Temporal trends in noninvasive and invasive cardiac testing from 2010 to 2022 in the US medicare population","volume":"18","author":"Cohen","year":"2025","journal-title":"Circ Cardiovasc Imaging"},{"key":"10.1016\/j.jcct.2026.06.011_bib2","article-title":"Diagnosis of obstructive coronary artery disease using computed tomography angiography in patients with stable chest pain depending on clinical probability and in clinically important subgroups: meta-analysis of individual patient data","volume":"365","author":"Haase","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.jcct.2026.06.011_bib3","doi-asserted-by":"crossref","first-page":"3415","DOI":"10.1093\/eurheartj\/ehae177","article-title":"2024 ESC guidelines for the management of chronic coronary syndromes","volume":"45","author":"Vrints","year":"2024","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jcct.2026.06.011_bib4","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.jcmg.2022.10.022","article-title":"National trends in coronary artery disease imaging: associations with health care outcomes and costs","volume":"16","author":"Weir-McCall","year":"2023","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jcct.2026.06.011_bib5","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1016\/j.jacc.2019.07.085","article-title":"Guiding therapy by coronary CT angiography improves outcomes in patients with stable chest pain","volume":"74","author":"Adamson","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jcct.2026.06.011_bib6","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1056\/NEJMoa2200963","article-title":"CT or invasive coronary angiography in stable chest pain","volume":"386","author":"Maurovich-Horvat","year":"2022","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jcct.2026.06.011_bib7","article-title":"Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial","volume":"355","author":"Dewey","year":"2016","journal-title":"BMJ"},{"key":"10.1016\/j.jcct.2026.06.011_bib8","doi-asserted-by":"crossref","first-page":"e187","DOI":"10.1016\/j.jacc.2021.07.053","article-title":"2021 AHA\/ACC\/ASE\/CHEST\/SAEM\/SCCT\/SCMR guideline for the evaluation and diagnosis of chest pain: a report of the American college of cardiology\/american heart association joint committee on clinical practice guidelines","volume":"78","author":"Gulati","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jcct.2026.06.011_bib9","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1016\/j.jcmg.2022.03.031","article-title":"The prognostic value of CAC zero among individuals presenting with chest pain: a meta-analysis","volume":"15","author":"Agha","year":"2022","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jcct.2026.06.011_bib10","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1093\/ehjci\/jeaf090","article-title":"Cardiac computed tomography for rule-out of ischaemic heart disease in patients with new-onset heart failure","volume":"26","author":"Graversen","year":"2025","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"10.1016\/j.jcct.2026.06.011_bib11","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.jcmg.2021.06.027","article-title":"Coronary calcium to rule out obstructive coronary artery disease in patients with acute chest pain","volume":"15","author":"Grandhi","year":"2022","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jcct.2026.06.011_bib12","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1001\/jamacardio.2021.4406","article-title":"Association of age with the diagnostic value of coronary artery calcium score for ruling out coronary stenosis in symptomatic patients","volume":"7","author":"Mortensen","year":"2022","journal-title":"JAMA Cardiol"},{"key":"10.1016\/j.jcct.2026.06.011_bib13","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1007\/s10554-025-03454-2","article-title":"The role of chest pain symptoms in predicting coronary artery disease severity and MACE events in patients with zero CAC: a study from a large CCTA cohort","volume":"41","author":"Yuan","year":"2025","journal-title":"Int J Cardiovasc Imag"},{"key":"10.1016\/j.jcct.2026.06.011_bib14","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1056\/NEJM197906143002402","article-title":"Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease","volume":"300","author":"Diamond","year":"1979","journal-title":"N Engl J Med"},{"issue":"11","key":"10.1016\/j.jcct.2026.06.011_bib15","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1093\/eurheartj\/ehr014","article-title":"A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension","volume":"32","author":"Genders","year":"2011","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jcct.2026.06.011_bib16","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.diii.2023.11.001","article-title":"A simple coronary CT angiography-based jeopardy score for the identification of extensive coronary artery disease: validation against invasive coronary angiography","volume":"105","author":"Schaab","year":"2024","journal-title":"Diagn Interventional Imaging"},{"key":"10.1016\/j.jcct.2026.06.011_bib17","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1016\/j.acra.2016.03.015","article-title":"Minimized radiation and contrast agent exposure for coronary computed tomography angiography: first clinical experience on a latest generation 256-slice scanner","volume":"23","author":"Benz","year":"2016","journal-title":"Acad Radiol"},{"key":"10.1016\/j.jcct.2026.06.011_bib18","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/0735-1097(90)90282-T","article-title":"Quantification of coronary artery calcium using ultrafast computed tomography","volume":"15","author":"Agatston","year":"1990","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jcct.2026.06.011_bib19","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.jcct.2014.07.003","article-title":"SCCT guidelines for the interpretation and reporting of coronary CT angiography: a report of the society of cardiovascular computed tomography guidelines committee","volume":"8","author":"Leipsic","year":"2014","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"10.1016\/j.jcct.2026.06.011_bib20","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.jcct.2022.07.002","volume":"16","author":"Cury","year":"2022","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"10.1016\/j.jcct.2026.06.011_bib21","doi-asserted-by":"crossref","first-page":"460","DOI":"10.2214\/AJR.23.29156","article-title":"High-speed On-Site deep learning-based FFR-CT algorithm: evaluation using invasive angiography as the reference standard","volume":"221","author":"Giannopoulos","year":"2023","journal-title":"AJR Am J Roentgenol"},{"issue":"3","key":"10.1016\/j.jcct.2026.06.011_bib22","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.jcct.2026.02.007","article-title":"Diagnostic performance of on-site, CT-derived fractional flow reserve in predicting invasive fractional flow reserve and absolute myocardial blood flow","volume":"20","author":"S\u00f8by","year":"2026","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"10.1016\/j.jcct.2026.06.011_bib23","doi-asserted-by":"crossref","first-page":"2421","DOI":"10.1016\/j.jacc.2020.09.585","article-title":"Incorporating coronary calcification into pre-test assessment of the likelihood of coronary artery disease","volume":"76","author":"Winther","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jcct.2026.06.011_bib24","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.annemergmed.2016.07.020","article-title":"Prognostic value of coronary artery calcium score in acute chest pain patients without known coronary artery disease: systematic review and meta-analysis","volume":"68","author":"Chaikriangkrai","year":"2016","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.jcct.2026.06.011_bib25","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.jcct.2021.03.007","article-title":"The accuracy of coronary CT angiography in patients with coronary calcium score above 1000 agatston units: Comparison with quantitative coronary angiography","volume":"15","author":"Kwan","year":"2021","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"10.1016\/j.jcct.2026.06.011_bib26","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.231557","article-title":"Coronary artery calcium score predicts major adverse cardiovascular events in stable chest pain","volume":"310","author":"Biavati","year":"2024","journal-title":"Radiology"},{"key":"10.1016\/j.jcct.2026.06.011_bib27","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jcct.2016.10.002","article-title":"SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: a report of the society of cardiovascular computed tomography guidelines committee: endorsed by the north American society for cardiovascular imaging (NASCI)","volume":"10","author":"Abbara","year":"2016","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"10.1016\/j.jcct.2026.06.011_bib28","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.123.016443","article-title":"Coronary atherosclerotic plaque burden assessment by computed tomography and its clinical implications","volume":"17","author":"Vatsa","year":"2024","journal-title":"Circ Cardiovasc Imaging"},{"key":"10.1016\/j.jcct.2026.06.011_bib29","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1001\/jama.2025.21077","article-title":"Coronary computed tomography angiography in prediction of first coronary events","volume":"335","author":"Bergstr\u00f6m","year":"2026","journal-title":"JAMA"},{"issue":"1","key":"10.1016\/j.jcct.2026.06.011_bib30","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1186\/s12872-020-01498-x","article-title":"Natural course of coronary artery calcium progression in Asian population with an initial score of zero","volume":"20","author":"Shen","year":"2020","journal-title":"BMC Cardiovasc Disord"},{"key":"10.1016\/j.jcct.2026.06.011_bib31","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2018-000945","article-title":"A zero coronary artery calcium score in patients with stable chest pain is associated with a good prognosis, despite risk of non-calcified plaques","volume":"6","author":"Wang","year":"2019","journal-title":"Open Heart"},{"key":"10.1016\/j.jcct.2026.06.011_bib32","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2020.619798","article-title":"A LASSO-derived risk model for subclinical CAC progression in Asian population with an initial score of zero","volume":"7","author":"Wu","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"10.1016\/j.jcct.2026.06.011_bib33","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2025.1628622","article-title":"A LASSO-Based predictive nomogram for obstructive coronary artery disease in double zero score patients: validation and cardiovascular education strategies","volume":"12","author":"Liang","year":"2025","journal-title":"Front Cardiovasc Med"}],"container-title":["Journal of Cardiovascular Computed Tomography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934592526004065?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934592526004065?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T20:00:49Z","timestamp":1783108849000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1934592526004065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":33,"alternative-id":["S1934592526004065"],"URL":"https:\/\/doi.org\/10.1016\/j.jcct.2026.06.011","relation":{},"ISSN":["1934-5925"],"issn-type":[{"value":"1934-5925","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Coronary calcium to rule out obstructive coronary artery disease in patients with non-anginal chest pain","name":"articletitle","label":"Article Title"},{"value":"Journal of Cardiovascular Computed Tomography","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcct.2026.06.011","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Inc. on behalf of Society of Cardiovascular Computed Tomography.","name":"copyright","label":"Copyright"}]}}