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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Cardiovascular Disorders 1/2018

A simple prediction model to estimate obstructive coronary artery disease

BMC Cardiovascular Disorders > Ausgabe 1/2018
Shiqun Chen, Yong Liu, Sheikh Mohammed Shariful Islam, Hua Yao, Yingling Zhou, Ji-yan Chen, Qiang Li
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12872-018-0745-0) contains supplementary material, which is available to authorized users.



A simple noninvasive model to predict obstructive coronary artery disease (OCAD) may promote risk stratification and reduce the burden of coronary artery disease (CAD). This study aimed to develop pre-procedural, noninvasive prediction models that better estimate the probability of OCAD among patients with suspected CAD undergoing elective coronary angiography (CAG).


We included 1262 patients, who had reliable Framingham risk variable data, in a cohort without known CAD from a prospective registry of patients referred for elective CAG. We investigated pre-procedural OCAD (≥50% stenosis in at least one major coronary vessel based on CAG) predictors.


A total of 945 (74.9%) participants had OCAD. The final modified Framingham scoring (MFS) model consisted of anemia, high-sensitivity C-reactive protein, left ventricular ejection fraction, and five Framingham factors (age, sex, total and high-density lipoprotein cholesterol, and hypertension). Bootstrap method (1000 times) revealed that the model demonstrated a good discriminative power (c statistic, 0.729 ± 0.0225; 95% CI, 0.69–0.77). MFS provided adequate goodness of fit (P = 0.43) and showed better performance than Framingham score (c statistic, 0.703 vs. 0.521; P < 0.001) in predicting OCAD, thereby identifying patients with high risks for OCAD (risk score ≥ 27) with ≥70% predictive value in 68.8% of subjects (range, 37.2–87.3% for low [≤17] and very high [≥41] risk scores).


Our data suggested that the simple MFS risk stratification tool, which is available in most primary-level clinics, showed good performance in estimating the probability of OCAD in relatively stable patients with suspected CAD; nevertheless, further validation is needed.
Additional file 1: Figure S1. Study flow. (PDF 54 kb)
Additional file 2: Table S1. Baseline Characteristics and incidence of obstructive coronary artery disease for patients with and without miss data of variables included in the final model. (DOCX 32 kb)
Additional file 3: Table S2. Multivariate logistic regression for the final modified Framingham model of complete and imputation data. (DOCX 19 kb)
Additional file 4: Table S3. Receiver operating characteristic curve for the final modified Framingham model of complete and imputation data. (DOCX 16 kb)
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