THE DIAGNOSTIC YIELD OF CORONARY ANGIOGRAPHY REMAINS LOW, DESPITE PRIOR MYOCARDIAL PERFUSION IMAGING TESTING, IN PATIENTS WITH SUSPECTED OBSTRUCTIVE CORONARY ARTERY DISEASE: RESULTS OF THE PREDICT (PERSONALIZED RISK EVALUATION AND DIAGNOSIS IN THE CORONARY TREE) TRIAL
| Autor: | Michael R. Elashoff, Hsiao Lieu, Mark Monane, Naeem Tahirkheli, Alexandra J. Lansky, Eric Topol, John A. McPherson, May Yau, Stephen G Ellis, Steven Rosenberg |
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| Jazyk: | angličtina |
| Předmět: |
Subset Analysis
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Lumen (anatomy) medicine.disease Asymptomatic Coronary artery disease Myocardial perfusion imaging Internal medicine Angiography medicine Cardiology In patient Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Cardiac catheterization |
| Zdroj: | Journal of the American College of Cardiology. (13):E171 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/S0735-1097(12)60172-7 |
| Popis: | Background: Non-invasive and invasive diagnostic studies for evaluating coronary artery disease (CAD) are on the rise. We examined the diagnostic yield of coronary angiography in patients with suspected obstructive coronary artery disease (CAD+) who had already undergone myocardial perfusion imaging (MPI) testing in a subset of the PREDICT trial, which validated a gene expression score for the detection of CAD+. Methods: The PREDICT trial was a prospective, multicenter study that enrolled patients referred for coronary angiography for the discovery, development, and validation of a gene expression score (GES) for the detection of obstructive CAD. Patients were referred for coronary angiography according to local practice, based on symptoms suggestive of CAD, high-risk clinical characteristics, and/or positive noninvasive stress test. In this subset, post-hoc analysis, evaluable nondiabetic patients were required to have both a MPI and coronary angiography. Local cardiologists interpreted CAD+ as left main disease ≥ 50% and/or epicardial coronary artery with ≥ 70% lumen obstruction. Results: We evaluated 1418 patients who underwent MPI followed by clinical angiography. The patients had an average age of 60 and 48% were female. Approximately, 78.1% (1107/1418) of the patients had possible (12.7%) or definite (65.3%) ischemia on MPI (MPI+). The overall yield for CAD+ in the MPI+ subgroup based on site-read angiograms, was 27.6% (37.2% for men and 16.2% for women, p value |
| Databáze: | OpenAIRE |
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