Computed tomography segmental calcium score (SCS) to predict stenosis severity of calcified coronary lesions

Autor: Ian Baron, Willem B. Meijboom, Gabriel P. Krestin, Marco Rengo, Marcel L. Dijkshoorn, Francesca Pugliese, Pim J. de Feyter, M. G. Myriam Hunink, Lu Zou, Katarzyna Gruszczynsnka
Přispěvatelé: Radiology & Nuclear Medicine
Rok vydání: 2015
Předmět:
Adult
Male
medicine.medical_specialty
Coronary Artery Disease
Coronary Angiography
Chest pain
Severity of Illness Index
atherosclerosis
computed tomography
coronary arteries
coronary calcification
coronary computed tomography angiography
adult
aged
aged
80 and over
algorithms
area under curve
chi-square distribution
coronary angiography
coronary artery disease
coronary stenosis
coronary vessels
female
humans
logistic models
male
middle aged
multivariate analysis
odds ratio
predictive value of tests
roc curve
reproducibility of results
severity of illness index
vascular calcification
young adult
decision support techniques
multidetector computed tomography
radiology
nuclear medicine and imaging
cardiology and cardiovascular medicine
Decision Support Techniques
Coronary artery disease
Young Adult
Predictive Value of Tests
Internal medicine
Multidetector Computed Tomography
Odds Ratio
medicine
Humans
Radiology
Nuclear Medicine and imaging
Myocardial infarction
Vascular Calcification
Aged
Aged
80 and over
Chi-Square Distribution
business.industry
Coronary Stenosis
Reproducibility of Results
Middle Aged
medicine.disease
Coronary Vessels
Confidence interval
Coronary arteries
Stenosis
Logistic Models
medicine.anatomical_structure
ROC Curve
Area Under Curve
Predictive value of tests
Multivariate Analysis
Cardiology
Female
Radiology
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Algorithms
Calcification
Zdroj: International Journal of Cardiovascular Imaging, 31(8), 1663-1675. Springer Netherlands
ISSN: 1573-0743
1569-5794
Popis: To estimate the probability of a parts per thousand yen50 % coronary stenoses based on computed tomography (CT) segmental calcium score (SCS) and clinical factors. The Institutional Review Board approved the study. A training sample of 201 patients underwent CT calcium scoring and conventional coronary angiography (CCA). All patients consented to undergo CT before CCA after being informed of the additional radiation dose. SCS and calcification morphology were assessed in individual coronary segments. We explored the predictive value of patient's symptoms, clinical history, SCS and calcification morphology. We developed a prediction model in the training sample based on these variables then tested it in an independent test sample. The odds ratio (OR) for a parts per thousand yen50 % coronary stenosis was 1.8-fold greater (p = 0.006) in patients with typical chest pain, twofold (p = 0.014) greater in patients with acute coronary syndromes, twofold greater (p < 0.001) in patients with prior myocardial infarction. Spotty calcifications had an OR for a parts per thousand yen50 % stenosis 2.3-fold (p < 0.001) greater than the absence of calcifications, wide calcifications 2.7-fold (p < 0.001) greater, diffuse calcifications 4.6-fold (p < 0.001) greater. In middle segments, each unit of SCS had an OR 1.2-fold (p < 0.001) greater than in distal segments; in proximal segments the OR was 1.1-fold greater (p = 0.021). The ROC curve area of the prediction model was 0.795 (0.95 confidence interval 0.602-0.843). Validation in a test sample of 201 independent patients showed consistent diagnostic performance. In conjunction with calcification morphology, anatomical location, patient's symptoms and clinical history, SCS can be helpful to estimate the probability of a parts per thousand yen50 % coronary stenosis.
Databáze: OpenAIRE
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