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dc.contributor.authorFladseth, Kristina
dc.contributor.authorKristensen, Andreas
dc.contributor.authorMannsverk, Jan
dc.contributor.authorTrovik, Thor
dc.contributor.authorSchirmer, Henrik
dc.date.accessioned2019-02-10T20:30:56Z
dc.date.available2019-02-10T20:30:56Z
dc.date.issued2018-11-01
dc.description.abstract<p><i>Objective</i>: Patients referred for acute coronary angiography (CAG) with unstable angina (UA) have low mortality and low rate of obstructive coronary artery disease (CAD). Better pre-test selection criteria are warranted. We aimed to assess the current guidelines against other clinical variables as predictors of obstructive CAD in patients with UA referred for acute CAG.</p> <p><i>Methods</i>: From 2005 to 2012, all CAGs performed at the University Hospital of North Norway, the sole provider of CAG in the region, were recorded in a registry. We included 979 admissions of UA and retrospectively collected data regarding presenting clinical parameters from patient hospital records. Obstructive CAD was defined as ≥50% stenosis and considered prognostically significant if found in the left main stem, proximal LAD or all three main coronary arteries. Characteristics were analysed by logistic regression analysis. A score was developed using ORs from significant factors in a multivariable model.</p> <p><i>Results</i> The overall rate of obstructive CAD was 45%, and the rate of prognostically significant CAD was 11%. The risk criteria recommended in American College of Cardiology/American Heart Association and European Society of Cardiology guidelines had an area under the curve (AUC) of 0.58. Adding clinical information increased the AUC to 0.77 (95% CI 0.74 to 0.80). Applying the derived score, we found that 56% (n=546) of patients had a score of <13, which was associated with a negative predictive value of 95% for prognostic significant CAD.</p> <p><i>Conclusions</i>: The current results suggest that CAG may be postponed or cancelled in more than half of patients with UA by improving pre-test selection criteria with the addition of clinical parameters to current guidelines.</p>en_US
dc.description.sponsorshipUiT The Arctic University of Norwayen_US
dc.descriptionSource at <a href=https://doi.org/10.1136/openhrt-2018-000888> https://doi.org/10.1136/openhrt-2018-000888</a>.en_US
dc.identifier.citationFladseth, K., Kristensen, A., Mannsverk, J., Trovik, T. & Schirmer, H. (2018). Pre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiography. <i>Open heart, 5</i>(2). https://doi.org/10.1136/openhrt-2018-000888en_US
dc.identifier.issn2053-3624
dc.identifier.otherFRIDAID 1637524
dc.identifier.other10.1136/openhrt-2018-000888
dc.identifier.urihttps://hdl.handle.net/10037/14665
dc.language.isoengen_US
dc.publisherBMJ Publishing Groupen_US
dc.relation.journalOpen heart
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771en_US
dc.titlePre-test characteristics of unstable angina patients with obstructive coronary artery disease confirmed by coronary angiographyen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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