Nuchanat Piyanop, Methavigul Komsing
Department of Cardiology, Central Chest Institute of Thailand, Nonthaburi 11000, Thailand.
Asian Biomed (Res Rev News). 2024 Sep 20;18(4):180-185. doi: 10.2478/abm-2024-0024. eCollection 2024 Aug.
Data about prediction of left main coronary artery disease (LMCAD)/three-vessel disease (TVD) in patients with chronic coronary syndromes (CCS) are lacking.
This study aimed to develop a model for predicting patients at risk of LMCAD/TVD.
This study used retrospective data from patients with CCS scheduled for invasive coronary angiography (ICA) and who were retrospectively recruited between January 2018 and December 2020. Predictors were obtained and analyzed by using logistic regression analysis, and generated the prediction score. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. The cut-off value and area under the curve (AUC) were analyzed by using the receiver operating characteristic (ROC) curve.
We recruited 162 patients with CCS. There were 75 patients in the non-LMCAD/TVD and 87 patients in the LMCAD/TVD groups. After the multivariate analysis, new onset of heart failure (HF) or left ventricular systolic dysfunction (LVSD) and suspected CAD, ST elevation (STE) in aVR, STE in V and lateral ST depression (STD) were associated with increased risk of LMCAD/TVD. Based on these 4 predictors, the prediction score was created. The cut-off value of the prediction score by using ROC curve analysis was 3.0. The sensitivity, specificity, PPV, and NPV were 71.26%, 86.67%, 86.11%, and 72.22%, respectively, with an AUC of 0.855.
The CCS patients with new onset of HF or LVSD and suspected CAD, STE in aVR, and STE in V and lateral STD were associated with increased risk of LMCAD/TVD. The novel prediction score could predict LMCAD/TVD in those patients with acceptable sensitivity, specificity, PPV, and NPV.
缺乏关于慢性冠状动脉综合征（CCS）患者左主干冠状动脉疾病（LMCAD）/三支血管疾病（TVD）预测的数据。
本研究旨在开发一种预测LMCAD/TVD风险患者的模型。
本研究使用了2018年1月至2020年12月期间回顾性招募的计划进行有创冠状动脉造影（ICA）的CCS患者的回顾性数据。通过逻辑回归分析获得并分析预测因素，并生成预测评分。计算敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。使用受试者工作特征（ROC）曲线分析截断值和曲线下面积（AUC）。
我们招募了162例CCS患者。非LMCAD/TVD组有75例患者，LMCAD/TVD组有87例患者。多变量分析后，新发心力衰竭（HF）或左心室收缩功能障碍（LVSD）以及疑似CAD、aVR导联ST段抬高（STE）、V导联STE和侧壁ST段压低（STD）与LMCAD/TVD风险增加相关。基于这4个预测因素，创建了预测评分。使用ROC曲线分析的预测评分截断值为3.0。敏感性、特异性、PPV和NPV分别为71.26%、86.67%、86.11%和72.22%，AUC为0.855。
新发HF或LVSD以及疑似CAD、aVR导联STE、V导联STE和侧壁STD的CCS患者与LMCAD/TVD风险增加相关。新的预测评分可以在可接受的敏感性、特异性、PPV和NPV情况下预测这些患者的LMCAD/TVD。
