MPS 03-03 A NEW RISK SCORE FOR PRE-TEST PROBABILITY OF OBSTRUCTIVE CORONARY ARTERY DISEASE IN HYPERTENSIVE PATIENTS

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Abstract

Objective:

No model has been developed to predict obstructive coronary artery disease (CAD) on invasive coronary arteriography (ICA) in hypertensive patients. Therefore, we sought to develop a model for the prediction of significant CAD on ICA in these high risk patients.

Design and Method:

We analyzed 1296 hypertensive patients with stable chest pain without a history of CAD and referred for invasive coronary arteriography (ICA) between 2007 and 2015. Primary outcome was obstructive CAD, defined as ≥ 50% stenosis in one or more vessels on ICA. Subjects were randomly assigned to either the training (n = 855) or validation (n = 441) cohort. The performance of the model was assessed by calculating the area under the receiver operating characteristic curve (c-statistic) and reclassification was determined.

Results:

Significant CAD was observed in 714 (55.1%). Our Model was accounted for age, male gender, hyperlipidemia, fasting blood-glucose, current smoking, ratio of total cholesterol to high-density lipoprotein cholesterol. The area under the receiver-operating characteristic (AUC) for the validation set (0.75, 95% CI 0.73–0.76) was almost equal to the performance achieved in the training set (AUC = 0.74, 95% CI 0.72–0.76). Our model outperformed the model of update Diamond-Forrest model recommended by recent guidelines, which had NRI of 82.60% (95% CI 69.1%-94.1%) and IDI of 13% (95% CI 10.46%-15.70%) in patients.

Conclusions:

We developed a model predicts significant CAD on ICA and has the potential to identify hypertensive patients with high risk.

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