ArticleThe American journal of medicine2015
Medical history for prognostic risk assessment and diagnosis of stable patients with suspected coronary artery disease.
Article in The American journal of medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Identification of Patients With Stable Chest Pain Deriving Minimal Value From Noninvasive Testing: The PROMISE Minimal-Risk Tool, A Secondary Analysis of a Randomized Clinical Trial.JAMA cardiology · 2017Trial
- Coronary CT Angiography as a Diagnostic and Prognostic Tool: Perspective from a Multicenter Randomized Controlled Trial: PROMISE.Current cardiology reports · 2016Trial
- Developing an ML-Based Pretest Probability Model of Obstructive CAD in Patients With Stable Chest Pain.JACC. Asia · 2025Article
- Approach to acute chest pain and acute coronary syndrome in adults.Singapore medical journal · 2024Article
- RNA sequencing of blood in coronary artery disease: involvement of regulatory T cell imbalance.BMC medical genomics · 2021Article
- Incremental value of QT interval for the prediction of obstructive coronary artery disease in patients with chest pain.Scientific reports · 2021Article
- A Risk-Stratification Machine Learning Framework for the Prediction of Coronary Artery Disease Severity: Insights From the GESS Trial.Frontiers in cardiovascular medicine · 2021Article
- Estimating Pre-Test Probability of Coronary Artery Disease: Battle of the Scores in an Evolving CAD Landscape.JACC. Cardiovascular imaging · 2019Article
- Coronary calcium score improves the estimation for pretest probability of obstructive coronary artery disease and avoids unnecessary testing in individuals at low extreme of traditional risk factor burden: validation and comparison of CONFIRM score and genders extended model.BMC cardiovascular disorders · 2018Observational
- Predictors of severe stenosis at invasive coronary angiography in patients with normal myocardial perfusion imaging.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2018Article
- Prevalence of obstructive coronary artery disease and prognosis in patients with stable symptoms and a zero-coronary calcium score.European heart journal. Cardiovascular Imaging · 2017Observational
- Diagnostic testing to evaluate ischemic symptoms in women.Women's health (London, England) · 2016Article
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Authors and funding
31 authors.
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Abstract
objectiveTo develop a clinical cardiac risk algorithm for stable patients with suspected coronary artery disease based upon angina typicality and coronary artery disease risk factors.
methodsBetween 2004 and 2011, 14,004 adults with suspected coronary artery disease referred for cardiac imaging were followed: 1) 9093 patients for coronary computed tomography angiography (CCTA) followed for 2.0 years (CCTA-1); 2) 2132 patients for CCTA followed for 1.6 years (CCTA-2); and 3) 2779 patients for exercise myocardial perfusion scintigraphy (MPS) followed for 5.0 years. A best-fit model from CCTA-1 for prediction of death or myocardial infarction was developed, with integer values proportional to regression coefficients. Discrimination was assessed using C-statistic. The validated model was tested for estimation of the likelihood of obstructive coronary artery disease, defined as ≥50% stenosis, as compared with the method of Diamond and Forrester. Primary outcomes included all-cause mortality and nonfatal myocardial infarction. Secondary outcomes included prevalent angiographically obstructive coronary artery disease.
resultsIn CCTA-1, best-fit model discriminated individuals at risk of death or myocardial infarction (C-statistic 0.76). The integer model ranged from 3 to 13, corresponding to 3-year death risk or myocardial infarction of 0.25% to 53.8%. When applied to CCTA-2 and MPS cohorts, the model demonstrated C-statistics of 0.71 and 0.77, respectively. Both best-fit (C = 0.76; 95% confidence interval [CI], 0.746-0.771) and integer models (C = 0.71; 95% CI, 0.693-0.719) performed better than Diamond and Forrester (C = 0.64; 95% CI, 0.628-0.659) for estimating obstructive coronary artery disease.
conclusionsFor stable symptomatic patients with suspected coronary artery disease, we developed a history-based method for prediction of death and obstructive coronary artery disease.
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