To the Editor,

I have read with great interest the article entitled “Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease” by Siqueira et al., recently published in Arquivos Brasileiros de Cardiologia 2016; 107:367-74. The investigators reported the possibility of removing extensive coronary artery disease (CAD) by means of a zero calcium score, or by indicating the presence of an extensive disease when it is severely increased, which justifies the use of this method in the initial or joint evaluation in asymptomatic patients with suspected CAD and in cardiovascular risk stratification. The evaluation of symptomatic low-risk patients, despite suggestive evidence, should be re-evaluated in upcoming guidelines.

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