Association between global longitudinal strain and coronary artery calcium in the diagnosis of significant coronary artery disease

Abstract Introduction Non-invasive diagnostic methods for coronary artery disease (CAD) are gaining increasing importance due to their accessibility, diagnostic value, safety, and cost-effectiveness. Both global longitudinal strain (GLS) and coronary artery calcium (CAC) scores have demonstrated high diagnostic utility. However, the combined use of these modalities remains insufficiently studied. Objective To evaluate the diagnostic effectiveness of GLS and CAC in detecting significant CAD and to determine whether their combined application provides superior diagnostic value compared to each method used independently. Materials and Methods This prospective cross-sectional study included 163 patients referred to our clinic for invasive coronary angiography to assess suspected CAD. All patients additionally underwent transthoracic echocardiography with GLS measurement, and non-contrast cardiac computed tomography with CAC scoring using the Agatston method. Exclusion criteria included acute coronary syndrome, heart failure (left ventricular ejection fraction