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PREVALENCE OF CORONARY ARTERY OBSTRUCTION ON MULTISLICE COMPUTED TOMOGRAPHY AND A PREDICTIVE MODEL IN PATIENTS WITH SUSPECTED CHRONIC CORONARY ARTERY DISEASE
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Abstract
Background: According to the 2024 European Society of Cardiology guidelines, coronary computed tomography angiography (MSCT) with contrast is recommended for patients with suspected chronic coronary artery disease (CAD) who have a low to intermediate pre-test probability. However, in real-world clinical practice, obstructive CAD may still be observed in patients with very low pre-test probability. This study was conducted to provide additional evidence for the diagnosis and treatment of patients with suspected chronic CAD. Objective: To determine the prevalence of obstructive coronary artery disease and to develop a predictive model for obstruction in patients with suspected chronic CAD. Methods: This descriptive cross-sectional study collected data from paper and electronic medical records and through patient interviews conducted at the MSCT imaging department of the Heart Institute of Ho Chi Minh City. Results: Among the 415 patients included, 174 (42%) had a very low pre-test probability (Group 1), while 241 (58%) were classified as having low to intermediate probability (Group 2). The overall prevalence of obstructive CAD was 22.4%, with 12% in Group 1 and 30% in Group 2. The logistic regression model demonstrated fair discriminative ability with AUC = 0.74. Conclusion: A very low pre-test probability does not exclude the presence of obstructive coronary artery disease. A predicted probability (p) greater than 0.6 indicates a high likelihood of obstructive CAD, with a positive predictive value of 73%.
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Keywords
: Obstructive coronary artery disease, chronic coronary syndrome, multislice computed tomography coronary angiography, predictive model.
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