The coronary calcium score is a more accurate predictor of significant coronary stenosis than conventional risk factors in symptomatic patients

Euro-CCAD study

R Nicoll, U Wiklund, Y Zhao, A Diederichsen, H Mickley, K Ovrehus, P Zamorano, P Gueret, A Schmermund, E Maffei, F Cademartiri, M Budoff, M Henein

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

AIMS: In this retrospective study we assessed the predictive value of the coronary calcium score for significant (>50%) stenosis relative to conventional risk factors.

METHODS AND RESULTS: We investigated 5515 symptomatic patients from Denmark, France, Germany, Italy, Spain and the USA. All had risk factor assessment, computed tomographic coronary angiogram (CTCA) or conventional angiography and a CT scan for coronary artery calcium (CAC) scoring. 1539 (27.9%) patients had significant stenosis, 5.5% of whom had zero CAC. In 5074 patients, multiple binary regression showed the most important predictor of significant stenosis to be male gender (B=1.07) followed by diabetes mellitus (B=0.70) smoking, hypercholesterolaemia, hypertension, family history of CAD and age but not obesity. When the log transformed CAC score was included, it became the most powerful predictor (B=1.25), followed by male gender (B=0.48), diabetes, smoking, family history and age but hypercholesterolaemia and hypertension lost significance. The CAC score is a more accurate predictor of >50% stenosis than risk factors regardless of the means of assessment of stenosis. The sensitivity of risk factors, CAC score and the combination for prediction of >50% stenosis when measured by conventional angiogram was considerably higher than when assessed by CTCA but the specificity was considerably higher when assessed by CTCA. The accuracy of CTCA for predicting >50% stenosis using the CAC score alone was higher (AUC=0.85) than using a combination of the CAC score and risk factors with conventional angiography (AUC=0.81).

CONCLUSION: In symptomatic patients, the CAC score is a more accurate predictor of significant coronary stenosis than conventional risk factors.

OriginalsprogEngelsk
TidsskriftInternational Journal of Cardiology
Vol/bind207
Sider (fra-til)13-19
ISSN0167-5273
DOI
StatusUdgivet - 8. jan. 2016

Fingeraftryk

Pathologic Constriction
Hypercholesterolemia
Area Under Curve
Smoking
Denmark
Italy
France
Germany
Diabetes Mellitus
Retrospective Studies

Citer dette

Nicoll, R ; Wiklund, U ; Zhao, Y ; Diederichsen, A ; Mickley, H ; Ovrehus, K ; Zamorano, P ; Gueret, P ; Schmermund, A ; Maffei, E ; Cademartiri, F ; Budoff, M ; Henein, M. / The coronary calcium score is a more accurate predictor of significant coronary stenosis than conventional risk factors in symptomatic patients : Euro-CCAD study. I: International Journal of Cardiology. 2016 ; Bind 207. s. 13-19.
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title = "The coronary calcium score is a more accurate predictor of significant coronary stenosis than conventional risk factors in symptomatic patients: Euro-CCAD study",
abstract = "AIMS: In this retrospective study we assessed the predictive value of the coronary calcium score for significant (>50{\%}) stenosis relative to conventional risk factors.METHODS AND RESULTS: We investigated 5515 symptomatic patients from Denmark, France, Germany, Italy, Spain and the USA. All had risk factor assessment, computed tomographic coronary angiogram (CTCA) or conventional angiography and a CT scan for coronary artery calcium (CAC) scoring. 1539 (27.9{\%}) patients had significant stenosis, 5.5{\%} of whom had zero CAC. In 5074 patients, multiple binary regression showed the most important predictor of significant stenosis to be male gender (B=1.07) followed by diabetes mellitus (B=0.70) smoking, hypercholesterolaemia, hypertension, family history of CAD and age but not obesity. When the log transformed CAC score was included, it became the most powerful predictor (B=1.25), followed by male gender (B=0.48), diabetes, smoking, family history and age but hypercholesterolaemia and hypertension lost significance. The CAC score is a more accurate predictor of >50{\%} stenosis than risk factors regardless of the means of assessment of stenosis. The sensitivity of risk factors, CAC score and the combination for prediction of >50{\%} stenosis when measured by conventional angiogram was considerably higher than when assessed by CTCA but the specificity was considerably higher when assessed by CTCA. The accuracy of CTCA for predicting >50{\%} stenosis using the CAC score alone was higher (AUC=0.85) than using a combination of the CAC score and risk factors with conventional angiography (AUC=0.81).CONCLUSION: In symptomatic patients, the CAC score is a more accurate predictor of significant coronary stenosis than conventional risk factors.",
author = "R Nicoll and U Wiklund and Y Zhao and A Diederichsen and H Mickley and K Ovrehus and P Zamorano and P Gueret and A Schmermund and E Maffei and F Cademartiri and M Budoff and M Henein",
note = "Copyright {\circledC} 2016 Elsevier Ireland Ltd. All rights reserved.",
year = "2016",
month = "1",
day = "8",
doi = "10.1016/j.ijcard.2016.01.056",
language = "English",
volume = "207",
pages = "13--19",
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The coronary calcium score is a more accurate predictor of significant coronary stenosis than conventional risk factors in symptomatic patients : Euro-CCAD study. / Nicoll, R; Wiklund, U; Zhao, Y; Diederichsen, A; Mickley, H; Ovrehus, K; Zamorano, P; Gueret, P; Schmermund, A; Maffei, E; Cademartiri, F; Budoff, M; Henein, M.

I: International Journal of Cardiology, Bind 207, 08.01.2016, s. 13-19.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - The coronary calcium score is a more accurate predictor of significant coronary stenosis than conventional risk factors in symptomatic patients

T2 - Euro-CCAD study

AU - Nicoll, R

AU - Wiklund, U

AU - Zhao, Y

AU - Diederichsen, A

AU - Mickley, H

AU - Ovrehus, K

AU - Zamorano, P

AU - Gueret, P

AU - Schmermund, A

AU - Maffei, E

AU - Cademartiri, F

AU - Budoff, M

AU - Henein, M

N1 - Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

PY - 2016/1/8

Y1 - 2016/1/8

N2 - AIMS: In this retrospective study we assessed the predictive value of the coronary calcium score for significant (>50%) stenosis relative to conventional risk factors.METHODS AND RESULTS: We investigated 5515 symptomatic patients from Denmark, France, Germany, Italy, Spain and the USA. All had risk factor assessment, computed tomographic coronary angiogram (CTCA) or conventional angiography and a CT scan for coronary artery calcium (CAC) scoring. 1539 (27.9%) patients had significant stenosis, 5.5% of whom had zero CAC. In 5074 patients, multiple binary regression showed the most important predictor of significant stenosis to be male gender (B=1.07) followed by diabetes mellitus (B=0.70) smoking, hypercholesterolaemia, hypertension, family history of CAD and age but not obesity. When the log transformed CAC score was included, it became the most powerful predictor (B=1.25), followed by male gender (B=0.48), diabetes, smoking, family history and age but hypercholesterolaemia and hypertension lost significance. The CAC score is a more accurate predictor of >50% stenosis than risk factors regardless of the means of assessment of stenosis. The sensitivity of risk factors, CAC score and the combination for prediction of >50% stenosis when measured by conventional angiogram was considerably higher than when assessed by CTCA but the specificity was considerably higher when assessed by CTCA. The accuracy of CTCA for predicting >50% stenosis using the CAC score alone was higher (AUC=0.85) than using a combination of the CAC score and risk factors with conventional angiography (AUC=0.81).CONCLUSION: In symptomatic patients, the CAC score is a more accurate predictor of significant coronary stenosis than conventional risk factors.

AB - AIMS: In this retrospective study we assessed the predictive value of the coronary calcium score for significant (>50%) stenosis relative to conventional risk factors.METHODS AND RESULTS: We investigated 5515 symptomatic patients from Denmark, France, Germany, Italy, Spain and the USA. All had risk factor assessment, computed tomographic coronary angiogram (CTCA) or conventional angiography and a CT scan for coronary artery calcium (CAC) scoring. 1539 (27.9%) patients had significant stenosis, 5.5% of whom had zero CAC. In 5074 patients, multiple binary regression showed the most important predictor of significant stenosis to be male gender (B=1.07) followed by diabetes mellitus (B=0.70) smoking, hypercholesterolaemia, hypertension, family history of CAD and age but not obesity. When the log transformed CAC score was included, it became the most powerful predictor (B=1.25), followed by male gender (B=0.48), diabetes, smoking, family history and age but hypercholesterolaemia and hypertension lost significance. The CAC score is a more accurate predictor of >50% stenosis than risk factors regardless of the means of assessment of stenosis. The sensitivity of risk factors, CAC score and the combination for prediction of >50% stenosis when measured by conventional angiogram was considerably higher than when assessed by CTCA but the specificity was considerably higher when assessed by CTCA. The accuracy of CTCA for predicting >50% stenosis using the CAC score alone was higher (AUC=0.85) than using a combination of the CAC score and risk factors with conventional angiography (AUC=0.81).CONCLUSION: In symptomatic patients, the CAC score is a more accurate predictor of significant coronary stenosis than conventional risk factors.

U2 - 10.1016/j.ijcard.2016.01.056

DO - 10.1016/j.ijcard.2016.01.056

M3 - Journal article

VL - 207

SP - 13

EP - 19

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -