Pre-test probability estimation of coronary artery disease can be improved by adding an acoustic-based risk score

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-04-01 DOI:10.1016/j.ijcha.2025.101672

Louise H Bjerking , Samuel E Schmidt , Kim W Skak-Hansen , Simon Winther , Morten Böttcher , Søren Galatius , Eva Prescott

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引用次数: 0

Abstract

Background

The American Heart Association/American College of Cardiology (AHA/ACC) 2021 Chest Pain Guidelines introduced a new pre-test probability (PTP) model for obstructive coronary artery disease (CAD). The model recommends a 15 % risk cut-off for referral for further testing. Whether addition of a risk score measured from acoustic detection of coronary turbulence obtained by the noninvasive device CADScor®System (CAD-score) improves the AHA/ACC-PTP capability to assign the correct risk category has not been tested.

Methods

Patients with symptoms suggestive of CAD referred for coronary CT angiography and undergoing a same-day CAD-score were included. PTP was calculated based on sex, age, and symptoms. All patients with suspected stenosis on CT angiography were referred for invasive angiography. A CAD-score ≤ 20 was used as cut-off for low likelihood of CAD.

Results

The study population consisted of 2874 patients (47 % women, median age [IQR] 58 [52–65] years). PTP categorized 2044 (71 %) of patients as > 15 % amongst whom 387 (18.9 %) were re-classified to low likelihood by a CAD-score ≤ 20. In patients aged < 70 without hypertension, 37 % were re-classified to low probability. Of the 830 patients with low PTP ≤ 15 %, 68.7 % had a CAD-score ≤ 20 indicating a deferred testing strategy.

Conclusion

Adding an acoustic-based CAD-score to the PTP in patients with AHA/ACC defined-PTP > 15 % risk can reduce the number of diagnostic tests by overall 19 %, and 37 % in subgroups, and may support cost-effective clinical decision-making. Moreover, CAD-score may aid risk stratification in patients, particularly with AHA/ACC-PTP ≤ 15 %.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.