Validation of a novel clinical prediction score for severe coronary artery diseases before elective coronary angiography.
Validation of a novel clinical prediction score for severe coronary artery diseases before elective coronary angiography.
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选择性冠状动脉造影前严重冠状动脉疾病的新型临床预测评分的验证
DOI：
10.1371/journal.pone.0094493
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Ge JB
中科院分区：
文献类型：
--
作者：
Chen ZW;Chen YH;Qian JY;Ma JY;Ge JB
冠状动脉疾病（CAD）的严重程度与患者预后相关。然而，很少有有效的评分系统已被开发出来，以筛选严重的CAD患者稳定型心绞痛和可疑的CAD冠状动脉造影术前。在这里，我们提出了一个新的评分系统，冠心病严重程度之前，选择性冠状动脉造影。551例稳定型心绞痛患者因冠状动脉造影而入院。患者被分为训练（n = 347）和验证（n = 204）队列。 重度CAD定义为Gensini评分≥ 20。所有患者均行超声心动图（ECG）检查，检测射血分数和主动脉瓣钙化（AVC）。应用多变量分析确定独立的危险因素并建立评分系统。在训练队列中，通过多变量分析，将年龄、男性、AVC、异常ECG、糖尿病、高脂血症、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇确定为严重CAD的独立因素，并开发了严重预测评分（SPS）系统。严重CAD的受试者工作特征（ROC）曲线的C指数在训练组和验证组分别为0.744和0.710。SPS系统在校准期间也表现良好，如验证组中的Hosmer-Lemeshow分析所示。与Diamond-Forrester评分相比，SPS系统在择期冠状动脉造影术前预测严重CAD方面表现更好。通过分析年龄、性别、AVC、ECG、糖尿病状态和血脂水平来预测严重CAD。使用该预测系统获得高分的心绞痛患者应早期进行冠状动脉造影。
Coronary artery disease (CAD) severity is associated with patient prognosis. However, few efficient scoring systems have been developed to screen severe CAD in patients with stable angina and suspected CAD before coronary angiography. Here, we present a novel scoring system for CAD severity before elective coronary angiography. Five hundred fifty-one patients with stable angina who were admitted for coronary angiography were enrolled in this study. Patients were divided into training (n = 347) and validation (n = 204) cohorts. Severe CAD was defined as having a Gensini score of 20 or more. All patients underwent echocardiography (ECG) to detect ejection fraction and aortic valve calcification (AVC). Multivariable analysis was applied to determine independent risk factors and develop the scoring system. In the training cohort, age, male sex, AVC, abnormal ECG, diabetes, hyperlipidemia, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were identified as independent factors for severe CAD by multivariable analysis, and the Severe Prediction Scoring (SPS) system was developed. C-indices of receiver operating characteristic (ROC) curves for severe CAD were 0.744 and 0.710 in the training and validation groups, respectively. The SPS system also performed well during calibration, as demonstrated by Hosmer-Lemeshow analysis in the validation group. Compared with the Diamond-Forrester score, the SPS system performed better for severe CAD prediction before elective coronary angiography. Severe CAD prediction was achieved by analyzing age, sex, AVC, ECG, diabetes status, and lipid levels. Angina patients who achieve high scores using this predicting system should undergo early coronary angiography.
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影响因子：
39.3
作者：
Iung, B;Baron, G;Vahanian, A
通讯作者：
Vahanian, A
影响因子：
37.8
作者：
Wilson, PWF;D'Agostino, RB;Kannel, WB
通讯作者：
Kannel, WB
影响因子：
1.6
作者：
Chen, Zhang-wei;Qian, Ju-ying;Ge, Junbo
通讯作者：
Ge, Junbo
影响因子：
39.3
作者：
de Mulder, Maarten;Gitt, Anselm;Boersma, Eric
通讯作者：
Boersma, Eric
影响因子：
39.3
作者：
Niccoli, Giampaolo;Giubilato, Simona;Crea, Filippo
通讯作者：
Crea, Filippo