Probabilistic model for prediction of angiographically defined obstructive coronary artery disease using electron beam computed tomography calcium score strata.
Probabilistic model for prediction of angiographically defined obstructive coronary artery disease using electron beam computed tomography calcium score strata.
复制标题
使用电子束计算机断层扫描钙评分层预测血管造影定义的阻塞性冠状动脉疾病的概率模型。
DOI：
10.1161/01.cir.102.4.380
复制
发表时间：
2000
期刊：
影响因子：
37.8
通讯作者：
Peyser,PA
中科院分区：
文献类型：
--
作者：
Bielak,LF;Rumberger,JA;Sheedy2nd,PF;Schwartz,RS;Peyser,PA
背景-电子束CT（EBCT）是一种准确、无创的检测和量化冠状动脉钙化的方法，钙化是冠状动脉疾病（CAD）的标志。本调查研究的准确性EBCT检测阻塞性CAD（≥50%狭窄），并确定了最佳的冠状动脉钙化的数量，以促进临床decisionmaking.Methods和Results-Clinical研究患者（n=213）进行了检查，冠状动脉造影和EBCT（血管造影组），和765名研究参与者进行了检查，只有EBCT（nonangiography组）。在血管造影组中，53%患有梗阻性CAD。校正验证偏倚后，钙评分≥1的估计灵敏度和特异性分别为97.0%和72.4%。计算每个性别和2个年龄组中与阻塞性CAD相关的钙评分分层的似然比。在≥50岁的患者中，确定了每种性别的相同4个EBCT钙评分分层;似然比范围为0.03（钙评分0）至12.85（钙评分≥200）。在<50岁的患者中，每种性别的EBCT钙评分都有相同的3个分层;似然比范围从0.13（钙评分0）到190（钙评分≥100）。结论：≥50岁的患者中钙评分≥200，<50岁的患者中钙评分≥100，为任何性别的患者患有阻塞性CAD提供了强有力的证据。钙评分为0提供了≥50岁的患者没有阻塞性CAD的有力证据。
Background—Electron beam CT (EBCT) is an accurate, noninvasive method to detect and quantify coronary artery calcification, a marker of coronary artery disease (CAD). This investigation examined the accuracy of EBCT to detect obstructive CAD (≥50% stenosis) and determined the optimal strata for quantity of coronary artery calcification to facilitate clinical decision-making.Methods and Results—Clinical research patients (n=213) were examined with coronary angiography and EBCT (angiography group), and 765 research participants were examined with only EBCT (nonangiography group). Of the angiography group, 53% had obstructive CAD. After adjustment for verification bias, the estimated sensitivity and specificity for calcium score ≥1 were 97.0% and 72.4%, respectively. Likelihood ratios for strata of calcium score associated with obstructive CAD were calculated in each sex and 2 age groups. Among those ≥50 years old, the same 4 strata of EBCT calcium scores were identified in each sex; likelihood ratios ranged from 0.03 (calcium score 0) to 12.85 (calcium score ≥200). The same 3 strata of EBCT calcium scores were identified in each sex among those <50 years old; likelihood ratios ranged from 0.13 (calcium score 0) to 190 (calcium score ≥100).Conclusions—A calcium score ≥200 among those ≥50 years old and calcium score ≥100 among those <50 years old provided strong evidence that patients of either sex had obstructive CAD. A calcium score of 0 provided strong evidence that patients ≥50 years old did not have obstructive CAD.