Simon Winther, MD, PhD Associate professor Department of Cardiology, Gødstrup Hospital Herning, Denmark

17 Nov Simple Clinical Tool for Estimation of Obstructive Coronary Artery Disease

Posted at 11:34h in Author Interviews, Heart Disease, JACC by

MedicalResearch.com Interview with:

Simon Winther, MD, PhD Associate professor Department of Cardiology, Gødstrup Hospital Herning, Denmark

Dr. Winther

Simon Winther, MD, PhD
Associate professor
Department of Cardiology, Gødstrup Hospital
Herning, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Both European and American guidelines have traditionally recommended estimating the pre-test probability (PTP) of CAD based on the classic Diamond-Forrester approach using sex, age, and type of chest complaints. However, The European Society of Cardiology (ESC) has recently suggested a novel concept of Clinical Likelihood of CAD as a more comprehensive assessment of CAD probability but no strategy has been proposed.

I this study, we improve the estimation of the likelihood of obstructive coronary artery disease (CAD) by combining the classic pre-test probability model (Diamond–Forrester approach using sex, age, and symptoms) with clinical risk factors and coronary artery calcium score in symptomatic patients with suspected CAD. Hence, we propose a simple clinical tool for the individual estimation of clinical likelihood of CAD. The tool was developed by stepwise simplification of advanced machine learning models without significant loss of accuracy and the model were validated the both European and North American cohorts. 

MedicalResearch.com: What should readers take away from your report?

Response: Several research groups have developed advanced pre-test probability models. The novelty and strength of our new developed tool is that no calculations are needed, and all information can be extracted from a simple table and graph. Hence, the model is very easy to use in the clinic

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Our models need further external validation predominantly in non-Caucasian patients. Finally, it is time for randomized trials evaluating the diagnostic strategy of these models.

Citation:

Incorporating Coronary Calcification Into Pre-Test Assessment of the Likelihood of Coronary Artery Disease

Simon Winther, MD, PhD Samuel Emil Schmidt, MSc, PhD Thomas Mayrhofer, PhD Hans Erik Bøtker, MD, DMSci, PhD Udo Hoffmann, MD, MPH Pamela S. Douglas, MD William Wijns, MD, PhD Jeroen Bax, MD, PhD Louise Nissen, MD, PhD Vibeke Lynggaard, PhD Jens Juel Christiansen, MD, PhD Antti Saraste, MD, PhD Morten Bøttcher, MD, PhD Juhani Knuuti, MD, PhD
J Am Coll Cardiol. 2020 Nov, 76 (21) 2421–2432

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Last Updated on November 17, 2020 by Marie Benz MD FAAD

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