Journal de médecine vasculaire et de chirurgie

Abstrait

Predictive value of coronary calcium score above zero in coronary artery stenosis among middle aged Saudi patients referred to computed tomography

Sumaya Al Helali

The rapid socioeconomic growth in Saudi Arabia in the last few decades promoted negative lifestyle changes that increased subclinical and clinical coronary artery diseases (CAD). METHODS: Retrospective cross-sectional study was conducted among adult patients referred to (64 multidetector spiral) computed tomography for standard indications at the Prince Sultan Cardiac Centre (Riyadh, Saudi Arabia) between July 2007 and December 2017. Those with pre-existing CAD excluded from the study. Stenosis was assessed using post-test CT angiography and was recorded as ≤50% and >50% RESULTS: A total 2849 patients (1797 males and 1052 females) with an average age of 49.8±11.7 years were included in the current analysis. The prevalence of coronary stenosis was 34.9%. The prevalence of CCS>0 was 27.9% in all patients and 79.5% in those with coronary stenosis. Using operator receiver curve, CCS above zero (CCS>0) has the best discriminative ability irrespective of age and gender. The sensitivity, specificity, positive and negative predictive values of CCS>0 were 79.5%, 99.7%, 99.4%, and 90.1%, respectively. While specificity of CCS>0 was close to 100% irrespective of gender and age groups, sensitivity was better in older than younger age (55.3%, 79.4%, and 92.3% in those aged <45, 45-64, and ≥65 years and to less extent in males than females (80.2% versus 77.7%). The areas under the curve of CCS were 0.896 in all patients; 0.899 in males and 0.889 in females; 0.776, 0.895, and 0.962 in those aged <45, 45-64, and ≥65 years. After adjusting for traditional risk factors, the area under the curve was 0.942 in all patients; with minor differences by gender and age groups.