The Role of Pretest Factors and Cardiovascular Risk Factors in Predicting Obstructive Coronary Artery Disease

Background: How the role of cardiovascular risk factors (hypertension, diabetes, smoking, dyslipidemia, family history of premature cardiovascular disease) affect the prior probability of coronary artery disease? Data on the pretest probability of coronary artery disease and studies evaluating the impact of pretest risk factors and cardiovascular risk factors on the ability to diagnose obstructive chronic coronary artery disease as for the Vietnamese population still very small. So, we did the study: “The role of extended model in predicting obstructive coronary artery disease” to answer this question.

Materials and Methods: There were 198 patients who received invasive coronary angiography at Nguyen Trai Hospital from September 1, 2020 to August 30, 2022. This was a cross-sectional study. Results: There were 99 cases (50%) with chronic obstructive coronary artery disease and 99 cases (50%) with non chronic obstructive coronary artery disease, median age was 66 (IQR, 57-73), 56% of men, obesity was 34,3%. There were statistically significant independent associations between age, smoking, diabetes, hypertension, history of dyslipidemia, chest pain characteristics, LDL-cholesterol, and ST-T abnormalities and pathological Q waves on electrocardiogram with chronic obstructive coronary artery disease in multivariable logistic regression analysis with p<0.05. The area under the ROC curve of the classical model was 0.75 (95% CI 0.67-0.81), the clinical model was 0.82 (95% CI 0.77-0.88). Our extended model had the best predictive value for obstructive coronary artery disease with an area under the ROC curve of 0.86 (95% CI 0.8-0.92, p < 0.001).

Conclusions: The value of our extended model is also shown through high AUC, the model had the ability to distinguish well between groups of patients with or without the possibility of obstructive coronary artery disease. The model was built to help clinicians have more consulting tools and plan follow-up for patients.