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RISS 인기검색어
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- 저자 : Szymonifka, Jackie (검색결과 2 건)
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Rizvi, Asim,Han, Donghee,Danad, Ibrahim,Ó,Hartaigh, Brí,ain,Lee, Ji Hyun,Gransar, Heidi,Stuijfzand, Wijnand J.,Roudsari, Hadi Mirhedayati,Park, Mahn Won,Szymonifka, Jackie,Chang, Hyuk-Jae Elsevier 2018 JACC CARDIOVASCULAR IMAGING Vol.11 No.4
<P><B>Abstract</B></P> <P><B>Objectives</B></P> <P>The current meta-analysis aimed to evaluate the diagnostic performance of hybrid cardiac imaging techniques compared with stand-alone coronary computed tomography angiography (CTA) for assessment of obstructive coronary artery disease (CAD).</P> <P><B>Background</B></P> <P>The usefulness of coronary CTA for detecting obstructive CAD remains suboptimal at present. Myocardial perfusion imaging encompasses positron emission tomography, single-photon emission computed tomography, and cardiac magnetic resonance, which permit the identification of myocardial perfusion defects to detect significant CAD. A hybrid approach comprising myocardial perfusion imaging and coronary CTA may improve diagnostic performance for detecting obstructive CAD.</P> <P><B>Methods</B></P> <P>PubMed and Web of Knowledge were searched for relevant publications between January 1, 2000 and December 31, 2015. Studies using coronary CTA and hybrid imaging for diagnosis of obstructive CAD (a luminal diameter reduction of >50% or >70% by invasive coronary angiography) were included. In total, 12 articles comprising 951 patients and 1,973 vessels were identified, and a meta-analysis was performed to determine pooled sensitivity, specificity, and summary receiver-operating characteristic curves.</P> <P><B>Results</B></P> <P>On a per-patient basis, the pooled sensitivity of hybrid imaging was comparable to that of coronary CTA (91% vs. 90%; p = 0.28). However, specificity was higher for hybrid imaging versus coronary CTA (93% vs. 66%; p < 0.001). On a per-vessel basis, sensitivity for hybrid imaging against coronary CTA was comparable (84% vs. 89%; p = 0.29). Notably, hybrid imaging yielded a specificity of 95% versus 83% for coronary CTA (p < 0.001). Summary receiver-operating characteristic curves displayed improved discrimination for hybrid imaging beyond coronary CTA alone, on a per-vessel basis (area under the curve: 0.97 vs. 0.93; p = 0.047), although not on a per-patient level (area under the curve: 0.97 vs. 0.93; p = 0.132).</P> <P><B>Conclusions</B></P> <P>Hybrid cardiac imaging demonstrated improved diagnostic specificity for detection of obstructive CAD compared with stand-alone coronary CTA, yet improvement in overall diagnostic performance was relatively limited.</P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>
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Ó,Hartaigh, Brí,ain,Gransar, Heidi,Callister, Tracy,Shaw, Leslee J.,Schulman-Marcus, Joshua,Stuijfzand, Wijnand J.,Valenti, Valentina,Cho, Iksung,Szymonifka, Jackie,Lin, Fay Y.,Berman, Dan Elsevier 2018 JACC CARDIOVASCULAR IMAGING Vol.11 No.3
<P><B>Abstract</B></P> <P><B>Objectives</B></P> <P>The purpose of this study was to develop and validate a simple-to-use nomogram for prediction of 5-, 10-, and 15-year survival among asymptomatic adults.</P> <P><B>Background</B></P> <P>Simple-to-use prognostication tools that incorporate robust methods such as coronary artery calcium scoring (CACS) for predicting near-, intermediate- and long-term mortality are warranted.</P> <P><B>Methods</B></P> <P>In a consecutive series of 9,715 persons (mean age: 53.4 ± 10.5 years; 59.3% male) undergoing CACS, we developed a nomogram using Cox proportional hazards regression modeling that included: age, sex, smoking, hypertension, dyslipidemia, diabetes, family history of coronary artery disease, and CACS. We developed a prognostic index (PI) summing the number of risk points corresponding to weighted covariates, which was used to configure the nomogram. Validation of the nomogram was assessed by discrimination and calibration applied to a separate cohort of 7,824 adults who also underwent CACS.</P> <P><B>Results</B></P> <P>A total of 936 and 294 deaths occurred in the derivation and validation sets at a median follow-up of 14.6 years (interquartile range: 13.7 to 15.5 years) and 9.4 years (interquartile range: 6.8 to 11.5 years), respectively. The developed model effectively predicted 5-, 10-, and 15-year probability of survival. The PI displayed high discrimination in the derivation and validation sets (C-index 0.74 and 0.76, respectively), indicating suitable external performance of our nomogram model. The predicted and actual estimates of survival in each dataset according to PI quartiles were similar (though not identical), demonstrating improved model calibration.</P> <P><B>Conclusions</B></P> <P>A simple-to-use nomogram effectively predicts 5-, 10- and 15-year survival for asymptomatic adults undergoing screening for cardiac risk factors. This nomogram may be considered for use in clinical care.</P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>
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