Cardiovascular risk scores in women undergoing stress myocardial perfusion scan and comparison with scan-predicted risk

AbstractBackground: Appropriate usage Criteria (AUC) for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. Objective: To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2009.Methods: We included records of patients who undergone MPS, from April 2016 up to August 2016. Demographic characteristics, patient's origin, coronary risk factors, clinical presentation, ECG, 2d echocardiogram, TMT and AUC of medical applications were studied. The criteria were evaluated by two independent cardiologists and, in doubtful cases, defined by a medical expert in MPS.Results: Total no of cases included in the study were 334 patients. Mean age was 62 ± 10 years. Of the 334 records reviewed, 201 (60.17%) studies were performed in men and 133 (39.8%) were performed in women. With ACC 2009, 168 (50.29%) were considered appropriate indications and 166 (49.70%) were considered inappropriate and uncertain indications. The AUC Sensitivity is 78.8, Specificity of 58.7%, Positive Predictive Value of 37.5% and Negative Predictive Value of 89.8%.Conclusions: In 63(18.8%) of patients MPS investigation is used appropriately to detect the CAD according to ACC & ASNC guidelines of 2009.

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Fuzzy Rule-Based Classification System for Assessing Coronary Artery Disease

Computational and Mathematical Methods in Medicine ◽

10.1155/2015/564867 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 14

Author(s):

Reza Ali Mohammadpour ◽

Seyed Mohammad Abedi ◽

Somayeh Bagheri ◽

Ali Ghaemian

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Myocardial Perfusion ◽

Fuzzy Rule ◽

Membership Functions ◽

Classification Result ◽

Rule Based ◽

Myocardial Perfusion Scan ◽

Perfusion Scan ◽

Artery Disease

The aim of this study was to determine the accuracy of fuzzy rule-based classification that could noninvasively predict CAD based on myocardial perfusion scan test and clinical-epidemiological variables. This was a cross-sectional study in which the characteristics, the results of myocardial perfusion scan (MPS), and coronary artery angiography of 115 patients, 62 (53.9%) males, in Mazandaran Heart Center in the north of Iran have been collected. We used membership functions for medical variables by reviewing the related literature. To improve the classification performance, we used Ishibuchi et al. and Nozaki et al. methods by adjusting the grade of certaintyCFjof each rule. This system includes 144 rules and the antecedent part of all rules has more than one part. The coronary artery disease data used in this paper contained 115 samples. The data was classified into four classes, namely, classes 1 (normal), 2 (stenosis in one single vessel), 3 (stenosis in two vessels), and 4 (stenosis in three vessels) which had 39, 35, 17, and 24 subjects, respectively. The accuracy in the fuzzy classification based on if-then rule was 92.8 percent if classification result was considered based on rule selection by expert, while it was 91.9 when classification result was obtained according to the equation. To increase the classification rate, we deleted the extra rules to reduce the fuzzy rules after introducing the membership functions.

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