Performance of the Traditional Age, Sex, and Angina Typicality-Based Approach for Estimating Pretest Probability of Angiographically Significant Coronary Artery Disease in Patients Undergoing Coronary Computed Tomographic Angiography: Results From the Multinational Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry (CONFIRM).
Circulation. 2011 Oct 24;
Authors: Cheng VY, Berman DS, Rozanski A, Dunning AM, Achenbach S, Al-Mallah M, Budoff MJ, Cademartiri F, Callister TQ, Chang HJ, Chinnaiyan K, Chow BJ, Delago A, Gomez M, Hadamitzky M, Hausleiter J, Karlsberg RP, Kaufmann P, Lin FY, Maffei E, Raff G, Villines TC, Shaw LJ, Min JK
BACKGROUND: <0.001 for all). Observed CAD50 and CAD70 prevalences were substantially lower than those predicted by guideline probabilities in the overall population (18% versus 51% for CAD50, 10% versus 42% for CAD70; P<0.001), driven by pronounced differences in patients with atypical angina (15% versus 47% for CAD50, 7% versus 37% for CAD70) and typical angina (29% versus 86% for CAD50, 19% versus 71% for CAD70). Marked overestimation of disease prevalence by guideline probabilities was found at all participating centers and across all sex and age subgroups.Conclusion-In this multinational study of patients referred for coronary computed tomographic angiography, determination of pretest likelihood of angiographically significant CAD by the invasive angiography-based guideline probabilities greatly overestimates the actual prevalence of disease.
PMID: 22025600 [PubMed - as supplied by publisher]