Introduction
Methods
Patients
CTA and Agatston scores
ICA
Statistical analysis
Results
Characteristics | n = 2452 |
---|---|
Age, y | 62 ± 10 |
Male sex, n (%) | 1603 (65.4) |
Agatston score | |
Median | 74.1 |
Range (minimum to maximum) | 0 to 6209.6 |
IQR | 1 to 389 |
Arterial hypertension, n (%)§ | 1332/2381 (55.9) |
Diabetes mellitus, n (%)§ | 442/2395 (18.5) |
Hyperlipidaemia, n (%)§ | 1172/2273 (51.6) |
Current smoker, n (%)§ | 708/2396 (29.5) |
Body mass index† | 26.8 ± 4.1 |
Prevalence of obstructive CAD on ICA | 1100 (44.9) |
Angina pectoris classification, n (%) | |
Typical angina | 1078 (44.0) |
Atypical angina | 746 (30.4) |
Nonanginal chest pain | 467 (19.0) |
Other chest discomfort | 161 (6.6) |
Pre-test probability, % | 49 ± 17 |
Diagnostic performance of CTA and Agatston score
Invasive coronary angiography | ||
---|---|---|
Positive | Negative | |
CTA | ||
Positive | 943 (85.7%) | 353 (26.1%) |
Negative | 157 (14.3%) | 999 (73.9%) |
Total | 1100 (100.0%) | 1352 (100.0%) |
Agatston score* | ||
Positive | 443 (40.3%) | 156 (11.5%) |
Negative | 657 (59.7%) | 1196 (88.5%) |
Total | 1100 (100.0%) | 1352 (100.0%) |
CTA | ||
---|---|---|
Positive | Negative | |
Agatston score§ | ||
Positive | 447 (18.2%) | 152 (6.2%) |
Negative | 849 (34.6%) | 1004 (41.0%) |
CTA n/total n (% [95% CI*]) | Agatston score§ n/total n (% [95% CI*]) | p-value* | |
---|---|---|---|
Diagnostic accuracy | 1942/2452 (81.1% [77.5 – 84.1]) | 1639/2452 (68.8% [64.2–73.1]) | < 0.0001 |
Sensitivity | 943/1100 (86.4% [83.7 – 88.7]) | 443/1100 (40.9% [36.6–45.3]) | < 0.0001 |
Specificity | 999/1352 (73.2% [69.5 – 76.6]) | 1196/1352 (88.2% [85.8–90.2]) | < 0.0001 |
Negative predictive value | 999/1156 (85.2% [81.3 – 88.3]) | 1196/1853 (64.1% [58.4–69.4]) | < 0.0001 |
Positive predictive value | 943/1296 (73.1% [67.9 – 77.8]) | 443/599 (75.8% [70.2–80.7]) | 0.2206 |
Positive likelihood ratio | 3.54 [2.61–4.81] | 3.10 [2.37–4.06] | |
Negative likelihood ratio | 0.14 [0.09–0.23] | 0.67 [0.60–0.75] | |
DOR | 31.42 [13.68–72.14] | 5.40 [3.60–8.09] |
Zero Agatston score
CTA accuracy in patients with higher Agatston scores
Discussion
Clinical implications
Comparison with previous studies
Current guidelines in light of our results
Limitations
Conclusion
Acknowledgements
Declarations
Guarantor
Conflict of interest
Statistics
Informed consent
Ethical approval
Methodology
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Prospective
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Diagnostic or prognostic study
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Multicentre study