Development and Validation of a Predictive Screening Tool for Uninterpretable Coronary CT Angiography Results
| Autor: | Patricia A. Peyser, Ryan D. Madder, Lawrence F. Bielak, Kavitha Chinnaiyan, Jim Edward Weber, Thomas E. Vanhecke |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Uninterpretable Coronary Artery Disease Coronary Angiography law.invention Young Adult Randomized controlled trial Predictive Value of Tests law Image Interpretation Computer-Assisted medicine Humans Mass Screening Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Aged Aged 80 and over Framingham Risk Score business.industry Reproducibility of Results Middle Aged United States Clinical trial Coronary arteries medicine.anatomical_structure Predictive value of tests Cohort Female Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Circulation: Cardiovascular Imaging. 4:490-497 |
| ISSN: | 1942-0080 1941-9651 |
| DOI: | 10.1161/circimaging.111.964205 |
| Popis: | Background— Coronary CT angiography (CCTA) is an excellent tool for noninvasive assessment of coronary arteries in low- to intermediate-risk individuals. However, the accuracy of CCTA heavily depends on image quality. Our objective was to develop and validate a tool to predict pre-CCTA risk of obtaining an uninterpretable result in symptomatic patients. Methods and Results— Among 8585 symptomatic patients, we identified variables independently associated with the presence of at least 1 uninterpretable major coronary segment to create the uninterpretable risk score (URS). This risk score was developed using both clinical variables and patient variables acquired at the time the CCTA was performed (heart rate and coronary calcium). The URS was then prospectively validated among an additional 915 symptomatic patients. The URS was predictive of uninterpretable results in both the development and the validation cohorts. For every 4-point increase in the URS (range, 0 to 12), the rate of at least 1 uninterpretable coronary segment per 100 CCTA studies increased ≈1.5 fold. Increased heart rate and coronary artery calcium score were predictive of uninterpretable CCTA study results. Uninterpretable results were associated with 3-month outcomes in the development cohort. Conclusions— The URS can categorize patients who are likely to have at least 1 uninterpretable major coronary segment on CCTA. This may aid in appropriate patient selection for CCTA and avoiding radiation exposure in those likely to have an uninterpretable study. Clinical Trial Registration— URL: http:///www.clinicaltrials.gov . Unique identifier: NCT00640068. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|