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Comparison of non-invasive methods for the detection of coronary atherosclerosis.

Bampi AB, Rochitte CE, Favarato D, Lemos PA, da Luz PL - Clinics (Sao Paulo) (2009)

Bottom Line: However, multivariate analysis indicated that only calcium score and low HDL-c levels correlated significantly with the extension of CAD.On the other hand, hs-CRP, LDL-c, flow-mediated dilation, and Framingham score did not correlate with the Friesinger index.ROC analysis showed that calcium score, HDL-c and TG-HDL ratio accurately predicted extensive CAD in a statistically significant manner.

View Article: PubMed Central - PubMed

Affiliation: Clinical Atherosclerosis Unit, Heart Institute (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil.

ABSTRACT

Background: Non-invasive detection of atherosclerosis is critical for its prevention.

Objective: To correlate non-invasively detectable indicators of coronary atherosclerosis, or Coronary Artery Disease (i.e., classical risk factors, hs-CRP test results, carotid intima-media thickness, endothelial function, ankle-brachial index and calcium score by computed tomography) with the extent of coronary disease assessed by the Friesinger index from conventional coronary angiography.

Methods: We conducted a prospective study of 100 consecutive patients, mean age 55.1 +/- 10.7 years, 55% men and 45% women. Patients with acute coronary syndrome, renal dialytic insufficiency, collagen disease and cancer were not included. All patients were subjected to clinical evaluation and laboratory tests. Endothelial function of the brachial artery and carotid artery were evaluated by high-resolution ultrasound; ankle-brachial index and computed tomography for coronary determination of calcium score were also performed, and non-HDL cholesterol and TG/HDL-c ratio were calculated. All patients were subjected to coronary angiography at the request of the assistant physician. We considered patients without an obstructive lesion (< 29% stenosis) demonstrated by coronary angiography to be normal.

Results: Univariate analysis showed that calcium score, HDL-c, TG/HDL ratio and IMT were significantly correlated with the Friesinger index. However, multivariate analysis indicated that only calcium score and low HDL-c levels correlated significantly with the extension of CAD. On the other hand, hs-CRP, LDL-c, flow-mediated dilation, and Framingham score did not correlate with the Friesinger index. ROC analysis showed that calcium score, HDL-c and TG-HDL ratio accurately predicted extensive CAD in a statistically significant manner.

Conclusion: It is possible to approximately determine the presence and extent of CAD by non-invasive methods, especially by calcium score, HDL-c and TG/HDL-c ratio assays.

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Related in: MedlinePlus

ROC curves by quartiles of Agatston, TG/HDL-c and HDL-c for patients with a Friesinger index ≥ 5
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f2-cln64_7p675: ROC curves by quartiles of Agatston, TG/HDL-c and HDL-c for patients with a Friesinger index ≥ 5

Mentions: When ROC curves were constructed using quartiles of these variables, the following ideal points emerged: calcium quartile 2.5, corresponding to 90% sensitivity and 80% specificity; TG/HDL-c ratio quartile 1.5 with 70% sensitivity and 60% specificity; HDL-C quartile 1.5 with 75% sensitivity and 65% specificity. ROC curves are shown in Figure 2.


Comparison of non-invasive methods for the detection of coronary atherosclerosis.

Bampi AB, Rochitte CE, Favarato D, Lemos PA, da Luz PL - Clinics (Sao Paulo) (2009)

ROC curves by quartiles of Agatston, TG/HDL-c and HDL-c for patients with a Friesinger index ≥ 5
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2710442&req=5

f2-cln64_7p675: ROC curves by quartiles of Agatston, TG/HDL-c and HDL-c for patients with a Friesinger index ≥ 5
Mentions: When ROC curves were constructed using quartiles of these variables, the following ideal points emerged: calcium quartile 2.5, corresponding to 90% sensitivity and 80% specificity; TG/HDL-c ratio quartile 1.5 with 70% sensitivity and 60% specificity; HDL-C quartile 1.5 with 75% sensitivity and 65% specificity. ROC curves are shown in Figure 2.

Bottom Line: However, multivariate analysis indicated that only calcium score and low HDL-c levels correlated significantly with the extension of CAD.On the other hand, hs-CRP, LDL-c, flow-mediated dilation, and Framingham score did not correlate with the Friesinger index.ROC analysis showed that calcium score, HDL-c and TG-HDL ratio accurately predicted extensive CAD in a statistically significant manner.

View Article: PubMed Central - PubMed

Affiliation: Clinical Atherosclerosis Unit, Heart Institute (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil.

ABSTRACT

Background: Non-invasive detection of atherosclerosis is critical for its prevention.

Objective: To correlate non-invasively detectable indicators of coronary atherosclerosis, or Coronary Artery Disease (i.e., classical risk factors, hs-CRP test results, carotid intima-media thickness, endothelial function, ankle-brachial index and calcium score by computed tomography) with the extent of coronary disease assessed by the Friesinger index from conventional coronary angiography.

Methods: We conducted a prospective study of 100 consecutive patients, mean age 55.1 +/- 10.7 years, 55% men and 45% women. Patients with acute coronary syndrome, renal dialytic insufficiency, collagen disease and cancer were not included. All patients were subjected to clinical evaluation and laboratory tests. Endothelial function of the brachial artery and carotid artery were evaluated by high-resolution ultrasound; ankle-brachial index and computed tomography for coronary determination of calcium score were also performed, and non-HDL cholesterol and TG/HDL-c ratio were calculated. All patients were subjected to coronary angiography at the request of the assistant physician. We considered patients without an obstructive lesion (< 29% stenosis) demonstrated by coronary angiography to be normal.

Results: Univariate analysis showed that calcium score, HDL-c, TG/HDL ratio and IMT were significantly correlated with the Friesinger index. However, multivariate analysis indicated that only calcium score and low HDL-c levels correlated significantly with the extension of CAD. On the other hand, hs-CRP, LDL-c, flow-mediated dilation, and Framingham score did not correlate with the Friesinger index. ROC analysis showed that calcium score, HDL-c and TG-HDL ratio accurately predicted extensive CAD in a statistically significant manner.

Conclusion: It is possible to approximately determine the presence and extent of CAD by non-invasive methods, especially by calcium score, HDL-c and TG/HDL-c ratio assays.

Show MeSH
Related in: MedlinePlus