Sensitivity, specificity of pre-test probability and their use in the relation to syntax score and cardiovascular risk factors

2021 ◽  
Author(s):  
Anh Binh Ho
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiovascular Risk Factors ◽  
European Society ◽  
Syntax Score ◽  
Model Group ◽  
European Society Of Cardiology ◽  
Test Probability

Overview: Coronary angiography is the gold standard for definitive diagnosis of obstructive ischemic coronary disease. However, this is an invasive, expensive test, and may have a number of complications. Models of pre-test probability (PTP) in the guideline of the European Society of Cardiology 2013 and 2019 are easy to use and apply even to doctors who are not cardiologists, and can be implemented at the medical facilities. We aim to assess the sensitivity and specificity of different PTP stratification models follow ESC2013 and 2019; and their use in the relation to SYNTAX score and cardiovascular risk factors. Materials and Methods: Patients (n=108) with chest pain had been treated at Ninh Thuan Provincial Hospital from January 2019 to May 2020. The PTP stratification models were calculated according to the recommendations of the European Society of Cardiology (ESC) 2013 and 2019. Coronary angiography was enrolled for the diagnosis, Quantitative coronary analyzed (QCA) - based stenosis assessment was used with a cut-off of ≥ 50% diameter reduction for significant lesions of coronary artery and SYNTAX score were calculated.Diagnostic accuracy was calculated by usingsensitivity, specificitywhich were analyzed by using statistical software SPSS version 20.0. Results: In the 2013 pre-test probability model,group withmedium PTP andhigh PTPhad the sensitivity of 57.14%, 100% respectively; the overall sensitivity for both groups (the medium and high pre-test) was 59.36%; and the specificity was 58.33%. In the 2019PTP model, group withmedium PTP and high PTP had the sensitivity of 41.67%, of 67.57% respectively;the overall sensitivity for both groups (the medium and high scores PTP) was 61.22%; and the specificity was 80%. The group of low SYNTAXscore (<23) had at most 93 cases, accounting for 86.1%; the lowest was the group of high SYNTAX score (≥ 33 points) accounting for 2.8%. There were statistically significant differences in patients with and without smoking, history of hypertension for both PTP model 2013 and 2019. Conclusion: Sensitivity and specificity of the 2013 and 2019 PTP were quite high in the relation to the severity of coronary artery which were evaluated by SYNTAX score.

scholarly journals Profile and treatment of chronic coronary syndromes in European Society of Cardiology member countries

2020 ◽  
pp. 204748732091249 ◽  
Author(s):  
Michel Komajda ◽  
Francesco Cosentino ◽  
Roberto Ferrari ◽  
Mathieu Kerneis ◽  
Elena Kosmachova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
European Society ◽  
Enzyme Inhibitor ◽  
Antiplatelet Agent ◽  
Initial Contact ◽  
Ambulatory Visit ◽  
Coronary Syndromes ◽  
European Society Of Cardiology

Background International guidelines recommend pharmacotherapy combinations for chronic coronary syndromes (CCSs) but medical management remains suboptimal. Design The CICD-LT registry is investigating short- and long-term outcomes and management in patients in European Society of Cardiology (ESC) member countries, in a longitudinal ESC EURObservational Research Programme aimed at improving CCS management. Methods Between 1 May 2015 and 31 July 2018, 9174 patients with previous ST-elevation myocardial infarction (STEMI), non-STEMI or coronary revascularisation, or other CCS, were recruited during a routine ambulatory visit or elective revascularisation procedure. Baseline clinical data were recorded and prescribed medications analysed at initial contact and discharge, and according to patient gender and age (<75 vs. ≥75 years). Results Poorly controlled cardiovascular risk factors, including current smoking (18.5%), obesity (33.9%), diabetes (25.8%), raised low-density lipoprotein cholesterol (73.3%) and persistent hypertension (24.7%), were common across all cohorts. At ambulatory visit or admission, the guidelines-recommended combination of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta-blocker, aspirin, statin and any antiplatelet agent was prescribed to 57.8% of patients with STEMI/NSTEMI. Differences in prescribing rates, including for combination therapies, were observed based on age and gender and persisted after adjustment for demographic factors. Conclusions Cardiovascular risk factors were common in contemporary CCS patients and secondary prevention prescribing was suboptimal. Patients aged ≥75 years and, to some extent, female patients were less likely to receive guidelines-recommended drug combinations than younger and male patients. One- and two-year follow-up will study prescribing changes and associations between baseline characteristics/prescribing and subsequent clinical outcomes.

Abstract 17353: Comparing the Association of DKK-1, a Wingless (Wnt)-Regulatory Molecule, and CRP-1 With Cardiovascular Risk Factor Profile and Coronary Plaque Burden in Patients With Coronary Artery Disease

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Benjamin Dao ◽  
Bishoy Elbebabawy ◽  
Ibrahim Sayid ◽  
Jagdesh Kandala ◽  
Harish Raj Seetha Rammohan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
Syntax Score ◽  
Artery Disease

Introduction: Our group has shown the Wnt-pathway to be a key regulator of SMC function and to be expressed in human coronary atheroma. Dickkopf-related protein 1 (DKK-1) is a member of the Wingless (Wnt) signaling pathway molecules and has recently been shown to improve GRACIE-risk factor score prediction of coronary events in chest pain patients and to predict restenosis post coronary stenting. We tested its association with coronary plaque burden and cardiovascular risk factors in comparison with CRP-1; Hypothesis: DKK-1 may be associated with coronary artery plaque burden and cardiovascular risk factors and play a role in coronary artery disease through modulation of SMC. Methods: 218 patients with angiographic evidence of CAD (mildly obstructive CAD, n=35; obstructive stable CAD, n=154; unstable CAD, n=29) were enrolled in this study at the time of cardiac catherization. DKK-1 and CRP-1 were measured by ELISA. Data are shown as Mean p SEM. Values of DKK-1 and CRP1 were skewed, so non-parametric tests were used to determine the associations between DKK-1 and CRP-1 with Syntax Score, age, BMI, LDL, HDL, and HgbA1c. . Spearman’s Rank Order Correlation, Wilcoxon Rank Sum Test, and analysis of variance (ANOVA) were used to assess associations. Results: Data are shown as Mean p SEM.Variables were as follows: DKK-1 736 pg/ml p 129, CRP-1 0.108 mg/ml p 0.01, age 66 years p 1, BMI 32 p 0.5, LDL 97 p 3, HDL 46 p 2, HgbA1C 6.5 p 0.2, Syntax score 11 p 0.7. With DKK-1 the only statistically significant correlation observed was between DKK-1 and HgbA1c (r=0.18, P<0.05). There was no association between DKK-1 and CRP-1, Syntax Score, Age, BMI, LDL, and HDL. With CRP-1, however, we observed significant positive correlations with Syntax Score (r=0.2, P<0.05), BMI (r=0.18, P<0.05), LDL (r=0.18, P<0.05) and significant negative correlation with age (r= -0.19, P<0.05) and with HDL (r=-0.18, P<0.05). There was no association between CRP-1 and HDL as well as HgbA1c. Conclusions: In patients with angiographically established CAD DKK-1 in contrast to CRP-1 is not a predictor of coronary plaque burden and has as only significant association a positive correlation with HgbA1c. Our data suggest that the reported role of DKK-1 in coronary event risk and in restenosis might be related to Diabetes mediated effects.

scholarly journals Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC)

2009 ◽  
Vol 24 (6) ◽  
pp. 412-424 ◽  
Author(s):  
M. De Hert ◽  
J.M. Dekker ◽  
D. Wood ◽  
K.G. Kahl ◽  
R.I.G. Holt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Mental Illness ◽  
Cardiovascular Risk ◽  
Severe Mental Illness ◽  
Cardiovascular Risk Factors ◽  
European Society ◽  
European Association ◽  
Mental Illnesses ◽  
European Society Of Cardiology

AbstractPeople with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed in part to an increased risk of the modifiable coronary heart disease risk factors; obesity, smoking, diabetes, hypertension and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain or worsen other metabolic cardiovascular risk factors. Patients may have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non-psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) published this statement with the aim of improving the care of patients suffering from severe mental illness. The intention is to initiate cooperation and shared care between the different healthcare professionals and to increase the awareness of psychiatrists and primary care physicians caring for patients with severe mental illness to screen and treat cardiovascular risk factors and diabetes.

scholarly journals Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis

2021 ◽  
Vol 10 (6) ◽  
pp. 1314
Author(s):  
Rebeca Lorca ◽  
Isaac Pascual ◽  
Andrea Aparicio ◽  
Alejandro Junco-Vicente ◽  
Rut Alvarez-Velasco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Young Women ◽  
Artery Dissection ◽  
Men And Women ◽  
High Prevalence

Background: Coronary artery disease (CAD) is the most frequent cause of ST-segment elevation myocardial infarction (STEMI). Etiopathogenic and prognostic characteristics in young patients may differ from older patients and young women may present worse outcomes than men. We aimed to evaluate the clinical characteristics and prognosis of men and women with premature STEMI. Methods: A total 1404 consecutive patients were referred to our institution for emergency cardiac catheterization due to STEMI suspicion (1 January 2014–31 December 2018). Patients with confirmed premature (<55 years old in men and <60 in women) STEMI (366 patients, 83% men and 17% women) were included (359 atherothrombotic and 7 spontaneous coronary artery dissection (SCAD)). Results: Premature STEMI patients had a high prevalence of classical cardiovascular risk factors. Mean follow-up was 4.1 years (±1.75 SD). Mortality rates, re-hospitalization, and hospital stay showed no significant differences between sexes. More than 10% of women with premature STEMI suffered SCAD. There were no significant differences between sexes, neither among cholesterol levels nor in hypolipemiant therapy. The global survival rates were similar to that expected in the general population of the same sex and age in our region with a significantly higher excess of mortality at 6 years among men compared with the general population. Conclusion: Our results showed a high incidence of cardiovascular risk factors, a high prevalence of SCAD among young women, and a generally good prognosis after standardized treatment. During follow-up, 23% suffered a major cardiovascular event (MACE), without significant differences between sexes and observed survival at 1, 3, and 6 years of follow-up was 96.57% (95% CI 94.04–98.04), 95.64% (95% CI 92.87–97.35), and 94.5% (95% CI 91.12–97.66). An extra effort to prevent/delay STEMI should be invested focusing on smoking avoidance and optimal hypolipemiant treatment both in primary and secondary prevention.

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