alexa Power of Contemporary Clinical Strategies to Detect Pat
ISSN: 2329-6925

Journal of Vascular Medicine & Surgery
Open Access

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Research Article

Power of Contemporary Clinical Strategies to Detect Patients with Obstructive Coronary Artery Disease

Ruben Ramos*, Pedro Rio, Tiago Pereira - da - Silva, Carlos Barbosa, Duarte Cacela, António Fiarresga, Lídia de Sousa, Ana Abreu, Lino Patrício, Luís Bernardes and Rui Cruz Ferreira

Department of Cardiology, Hospital de Santa Marta, Lisboa, Portugal

*Corresponding Author:
Ruben Ramos
Cardiology Service, Hospital de Santa Marta
1169-024, Rua de Santa Marta 50
Lisboa, Portugal
Fax: 00351-213560368
E-mail: [email protected]

Received Date: May 21, 2015; Accepted Date: December 14, 2015; Published Date: January 01, 2016

Citation: Ramos R, Rio P, da Silva TP, Barbosa C, Cacela D, et al. (2016) Power of Contemporary Clinical Strategies to Detect Patients with Obstructive Coronary Artery Disease. J Vasc Med Surg 4:243. doi:10.4172/2329-6925.1000243

Copyright: © 2016 Ramos R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Background: Non-invasive Ischemia Testing (NIST) is recommended for most patients suspected to have stable coronary artery disease (CAD) before invasive cardiac angiography (ICA). We sought to assess the diagnostic predictive ability of NIST over clinical risk profiling in a contemporary sample of patients undergoing the currently recommended diagnostic triage strategy. Methods and results: From 2006 - 2011, 2600 consecutive patients without known CAD undergoing elective ICA in a single tertiary - care centre were retrospectively identified and the prevalence of obstructive CAD determined. To understand the incremental value of frequently used clinical parameters in predicting obstructive CAD, receiver - operating - characteristic curves were plotted for six sequential models starting with Framingham risk score and then progressively adding multiple clinical factors and finally NIST results. At ICA 1268 patients (48.8%) had obstructive. The vast majority (85%) were classified in an intermediate clinical pre - test probability of CAD and NIST prior to ICA was used in 86% of the cohort. The most powerful correlate of obstructive CAD was the presence of severe angina (OR = 9.1, 95% confidence interval (CI), 4.3 - 19.1). Accordingly, the incorporation of NIST in a sequential model had no significant effect on the predictive ability over that achieved by clinical and symptomatic status model (C - statistic 0.754; 95% CI, 0.732 - 0.776, p = 0.28). Conclusions: Less than half the patients with suspect stable obstructive CAD referred to a tertiary level centre for elective ICA had the diagnosis confirmed. In this clinical setting, the results of NIST may not have the power to change the discriminative ability over clinical judgment alone.


Share This Page

Additional Info

Loading Please wait..
Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version