Chen et al reported a model for predicting obstructive coronary artery disease in an adult. It was based on the Framingham risk model. The authors are from Guangdong Academy of Medical Sciences in China and the University of Sydney in Australia.
Patient selection: adult >= 18 years of age
Parameters:
(1) age in years
(2) gender
(3) hypertension
(4) anemia
(5) left ventricular ejection fraction (LVEF) in percent
(6) serum total cholesterol in mg/dL (units in paper mmol/L)
(7) HDL cholesterol in mg/dL (units in paper mmol/L)
(8) high sensitivity CRP in mg/L (units in paper mmol/L)
|
Parameter |
Finding |
Points |
|
age in years |
18 to 44 years of age |
0 |
|
|
45 to 54 years of age |
2 |
|
|
55 to 64 years of age |
4 |
|
|
65 to 74 years of age |
6 |
|
|
>= 75 years of age |
8 |
|
gender |
female |
0 |
|
|
male |
11 |
|
hypertension |
no |
0 |
|
|
yes |
5 |
|
anemia |
no |
0 |
|
|
yes |
6 |
|
LVEF |
>= 50% |
0 |
|
|
40 to 49% |
5 |
|
|
< 40% |
7 |
|
serum total cholesterol |
< 160 mg/dL |
0 |
|
|
160 to 199 mg/dL |
3 |
|
|
200 to 239 mg/dL |
5 |
|
|
240 to 279 mg/dL |
7 |
|
|
>= 280 mg/dL |
9 |
|
HDL cholesterol |
>= 60 mg/dL |
0 |
|
|
50 to 59 mg/dL |
3 |
|
|
40 to 49 mg/dL |
6 |
|
|
< 40 mg/dL |
9 |
|
CRP |
<= 3 mg/L |
0 |
|
|
> 3 mg/L |
6 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 61
• The higher the score the greater the risk of obstructive coronary artery disease. Note that a score of 0 had a 16% incidence.
|
Total Score |
Risk Category |
Incidence Obstructive CAD |
|
0 to 17 |
low |
16 to 48% |
|
18 to 26 |
moderate |
50 to 68% |
|
27 to 41 |
high |
70 to 89% |
|
>= 42 |
very high |
90 to 98% |
|
Total Score |
Risk of Obstructive CAD |
|
0 to 2 |
16 to 19% |
|
3 to 8 |
20 to 29% |
|
9 to 13 |
31 to 39% |
|
14 to 17 |
41 to 48% |
|
18 to 22 |
50 to 59% |
|
23 to 26 |
62 to 68% |
|
27 to 32 |
70 to 79% |
|
33 to 41 |
80 to 89% |
|
>= 42 |
>= 90% |
Performance:
• The c-statistic is 0.73.
Specialty: Cardiology
