Ontology highlight
ABSTRACT: Background
Coronary artery calcium score (CAC) is an objective marker of atherosclerosis. The primary aim is to assess CAC as a risk classifier in stable coronary artery disease (CAD).Hypothesis
CAC improves CAD risk prediction, compared to conventional risk scoring, even in the absence of cardiovascular risk factor inputs.Methods
Outpatients presenting to a cardiology clinic (n = 3518) were divided into two cohorts: derivation (n = 2344 patients) and validation (n = 1174 patients). Adding logarithmic transformation of CAC, we built two logistic regression models: Model 1 with chest pain history and risk factors and Model 2 including chest pain history only without risk factors simulating patients with undiagnosed comorbidities. The CAD I Consortium Score (CCS) was the conventional reference risk score used. The primary outcome was the presence of coronary artery disease defined as any epicardial artery stenosis?50% on CT coronary angiogram.Results
Area under curve (AUC) of CCS in our validation cohort was 0.80. The AUC of Models 1 and 2 were significantly improved at 0.88 (95%CI 0.86-0.91) and 0.87 (95%CI 0.84-0.90), respectively. Integrated discriminant improvement was >15% for both models. At a pre-specified cut-off of ?10% for excluding coronary artery disease, the sensitivity and specificity were 89.3% and 74.7% for Model 1, and 88.1% and 71.8% for Model 2.Conclusion
CAC helps improve risk classification in patients with chest pain, even in the absence of prior risk factor screening.
SUBMITTER: Huang W
PROVIDER: S-EPMC7852173 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
Huang Weiting W Lim Leon Ming Hsien LMH Aurangzeb Amirzeb S/O AS Wong Cheney Jianlin CJ Koh Natalie Si Ya NSY Huang Zijuan Z Teo Hooi Khee HK Chua Terrance Siang Jin TSJ Tan Swee Yaw SY
Clinical cardiology 20210112 2
<h4>Background</h4>Coronary artery calcium score (CAC) is an objective marker of atherosclerosis. The primary aim is to assess CAC as a risk classifier in stable coronary artery disease (CAD).<h4>Hypothesis</h4>CAC improves CAD risk prediction, compared to conventional risk scoring, even in the absence of cardiovascular risk factor inputs.<h4>Methods</h4>Outpatients presenting to a cardiology clinic (n = 3518) were divided into two cohorts: derivation (n = 2344 patients) and validation (n = 1174 ...[more]