ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2023
External validation of the CRAX2MACE model.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Deep Learning-Derived Cardiac Chamber Volumes and Mass From PET/CT Attenuation Scans: Associations With Myocardial Flow Reserve and Heart Failure.Circulation. Cardiovascular imaging · 2025Article
- Impact of myocardial perfusion and coronary calcium on medical management for coronary artery disease.European heart journal. Cardiovascular Imaging · 2024Article
- Machine learning to predict abnormal myocardial perfusion from pre-test features.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundSingle-photon emission computed tomography (SPECT) myocardial perfusion is frequently used to predict risk of major adverse cardiovascular events (MACE). We performed an external validation of the CRAX2MACE score, developed to estimate 2-year risk of MACE in patients with suspected coronary artery disease (CAD).
methodsPatients who underwent clinically indicated SPECT with available follow-up for MACE were included (N = 2,985). The prediction performance for MACE (revascularization, myocardial infarction, or death) within 2 years for CRAX2MACE was compared with stress and ischemic total perfusion deficit (TPD) using area under the receiver operating characteristic curve (AUC). Calibration was assessed with calibration plots, Brier score, and the Hosmer-Lemeshow test.
resultsMACE occurred within 2 years in 243 (8.1%) patients. The AUC for CRAX2MACE (0.710, 95% CI 0.677-0.743) was significantly higher compared to stress TPD (AUC 0.669, 95% CI 0.632-0.706, P = .010) and ischemic TPD (AUC 0.664, 95% CI 0.627-0.700, P < .001). The model had acceptable goodness-of-fit (P = .103) and was well-calibrated with Brier score of 0.071.
conclusionCRAX2MACE had higher predictive performance for 2-year MACE than quantitative perfusion in an external population. The current model is simple to use and could be implemented to assist physicians when estimating patient risk.
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