Diagnostic value of clinical risk scores for predicting normal stress myocardial perfusion imaging in subjects without coronary artery calcium(51 visite) Megna R, Nappi C, Gaudieri V, Mannarino T, Assante R, Zampella E, Green R, Cantoni V, D'Antonio A, Arumugam P, Acampa W, Petretta M, Cuocolo A
J Nucl Cardiol, 2020 Jun 29; N/D: N/D-N/D.
Tipo di articolo: Journal Article
Impact factor: 4.112, Impact factor a 5 anni: 0
Url: Non disponibile.
Parole chiave: Cad; Mpi; Pet; Diagnostic And Prognostic Application.
*** IBB - CNR *** Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy. Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy. Department of Nuclear Medicine, Central Manchester Foundation Trust, Manchester, UK. Department of Translational Medical Sciences, University Federico II, Naples, Italy.
<h2 class="title"><br> Abstract<br> </h2><br> <div class="abstract-content selected" id="enc-abstract"><br> <strong class="sub-title"><br> Background:<br> </strong><br> We evaluated if risk scores commonly used to predict the absence <br>of significant stenosis at coronary computed tomography (CT) angiography<br> are useful to predict a normal stress myocardial perfusion imaging <br>(MPI) study.<br> <strong class="sub-title"><br> Methods:<br> </strong><br> Our cohort included a total of 1422 consecutive patients with zero coronary artery calcium score (ZCS) who underwent <sup>82</sup>Rb<br> PET/CT for evaluation of suspected coronary artery disease (CAD). <br>Predictive models were constructed as reported by Genders et al. and <br>Alshahrani et al., and the probability of abnormal summed stress score <br>(SSS) and of reduced myocardial perfusion reserve (MPR) based on these <br>risk scores was assessed.<br> <strong class="sub-title"><br> Results:<br> </strong><br> In the overall population, the prevalence of abnormal SSS was 0.10<br> and the prevalence of reduced MPR was 0.17 (both P < .001).The <br>observed frequencies of abnormal SSS and reduced MPR vs the <br>probabilities predicted by the Genders and Alshahrani models were above <br>the diagonal identity line, highlighting an underestimation of the <br>observed occurrence by these models. The areas under the receiver <br>operating characteristic curve of the Genders and Alshahrani models <br>indicated lack of discriminative ability for predicting abnormal SSS <br>(0.547 and 0.527) and reduced MPR (0.509 and 0.538). The Hosmer-Lemeshow<br> test revealed that both models underestimated the observed occurrence <br>of abnormal SSS and reduced MPR.<br> <strong class="sub-title"><br> Conclusions:<br> </strong><br> Available models were unable to identify among patients with ZCS <br>those with a low probability of a normal stress MPI study. Thus, an <br>optimal approach to rule out from MPI patients without detectable <br>coronary calcium still needs to be improved.<br>