Factors Associated with Non-calcified Plaques in Patients with Coronary Artery Calcium Score of Zero
| Autor: | Carlos Collaud, Juan M. Blanco, Marcela Redruello, Jorgelina Medus, Osvaldo Masoli, Lucas San Miguel, Enrique Sodor |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry Ischemia medicine.disease Logistic regression Asymptomatic Likelihood ratios in diagnostic testing medicine.anatomical_structure Internal medicine medicine Cardiology Stress Echocardiography medicine.symptom business Perfusion Depression (differential diagnoses) Artery |
| Zdroj: | Revista Argentina de Cardiologia. 88:315-321 |
| Popis: | Background: The coronary artery calcium score is used for risk stratification in asymptomatic patients. Although coronary arterydisease can occur in the absence of coronary artery calcifications, no conditions associated with the presence of soft non-calcifiedplaques have been described in this scenario, beyond the presence of symptoms.Objectives: The aim of this study was to determine the associations between non-calcified plaques and independent variables inpatients with coronary artery calcium score of zero.Methods: Consecutive patients with coronary artery score of zero Agatston units who also underwent computed tomography coronaryangiography were included in the study. Univariate logistic regression analysis was used to find associations. (15) Sensitivity,specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LH+) and negative likelihoodratio (LH-) were calculated.Results: Among a total of 93 patients, 10% (n = 9) presented non-calcified plaque. A positive exercise stress test was associated withplaques of any degree of severity (OR 6.5; 95% CI, 1.3-33, p = 0.02). This association persisted for non-severe plaques when the positiveexercise stress test was combined with a negative myocardial perfusion SPECT or stress echocardiography for ischemia (OR,12.4; 95% CI 1.5-101, p = 0.02). Sensitivity and specificity of ST-segment depression for non-calcified plaque of any degree of severitywas 44.4% and 86%, respectively, with NPV of 94%, PPV of 25%, LR+ of 3.11 and LR– of 0.65.Conclusions: ST-segment depression could be associated with non-calcified plaques in patients without coronary artery calcifications,even with normal exercise stress myocardial perfusion or wall motion (non-obstructive disease). |
| Databáze: | OpenAIRE |
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