Combining anatomical and biochemical markers in the detection and risk stratification of coronary artery disease
Authors' conclusion
The combination of the Ca-score with hs-cTnT increases the prognostic accuracy for future events but does not provide incremental value vs. the Ca-score alone for the diagnosis of fCAD.
Study context
- Population
- Consecutive patients without prior CAD undergoing myocardial perfusion SPECT (MPS)399 with fCAD
- Participants
- 1,715 patients
- Comparison
- Calcium score (Ca-score) combined with high-sensitivity cardiac troponin T (hs-cTnT) vs Ca-score alone for fCAD detection and risk stratification
- Outcome
- Diagnostic accuracy (AUC) for functionally relevant CAD (fCAD); primary prognostic endpoint: CV death or non-fatal AMI
- Follow-up
- 730 days (prognostic endpoint)
Methodological detailsprospective, consecutive patients, central adjudication, fCAD centrally adjudicated, based on ischaemia on MPS and coronary angiography
- Prospective
- Consecutive patients
- Central adjudication
- fCAD centrally adjudicated, based on ischaemia on MPS and coronary angiography
Performance
As reported in the abstract
Diagnosis of fCAD
| Test or model | AUC |
|---|---|
| Ca-score + hs-cTnT | 0.79 (95% CI 0.77-0.81) |
| Ca-score | 0.79 (95% CI 0.77-0.81) |
| Ca-score + hs-cTnI | 0.80 (95% CI 0.77-0.82) |
AUC
Ca-score + hs-cTnT0.79 (95% CI 0.77-0.81)
Ca-score0.79 (95% CI 0.77-0.81)
Ca-score + hs-cTnI0.80 (95% CI 0.77-0.82)
- Ca-score + hs-cTnT vs Ca-score: P = 0.965 — no incremental value
Further findings
CV death or non-fatal acute myocardial infarction (AMI) (primary prognostic endpoint) · 730 days
- Patients with the composite endpoint
- 59 (3.5%)
- Non-fatal AMI
- 34
- CV death
- 28
- Both Ca-score and hs-cTnT had independent prognostic value; increased risk restricted to patients with elevation in both markers
- 1709 (99.7%) with available follow-up
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Combining anatomical and biochemical markers in the detection and risk stratification of coronary artery disease. Eur Heart J Cardiovasc Imaging. Published 9 April 2024. doi:10.
Summarised from the published abstract; every number is checked against it