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. 2024 Jul 17;2(3):qyae075.
doi: 10.1093/ehjimp/qyae075. eCollection 2024 Jul.

ESC pre-test probability estimates for obstructive coronary artery disease: can they be used in Brazil?

Fernanda Erthal  1   2 , Ronaldo Lima  2   3 , Filipe Penna  2 , Benjamin J W Chow  4 , Ronaldo Gismondi  1
Affiliations

ESC pre-test probability estimates for obstructive coronary artery disease: can they be used in Brazil?

Fernanda Erthal et al. Eur Heart J Imaging Methods Pract. .

Abstract

Aims: Cardiovascular disease, primarily coronary artery disease (CAD), is the leading cause of mortality worldwide. Accurate diagnosis of CAD often requires pre-test probability (PTP) estimation, traditionally performed using scoring systems like the Diamond-Forrester (DF) and European Society of Cardiology (ESC) models. However, the applicability of such models in specific populations may vary. This study compares the performance of DF and PTP scores in the Brazilian context, using coronary computed tomography angiography (CCTA) as a reference standard.

Methods and results: PTP for obstructive CAD was calculated using DF and ESC scores in 409 symptomatic patients without known CAD who underwent CCTA between 2019 and 2022. Predicted PTP was compared with actual CAD prevalence. DF overestimated CAD prevalence across age and symptom categories, while ESC showed better alignment with actual prevalence.

Conclusion: Our study confirms that the ESC PTP model is more appropriate than the DF model for determining PTP in the Brazilian population.

Keywords: CCTA; PTP; coronary atherosclerotic disease.

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Conflict of interest statement

Conflict of interest: F.E.: Nothing to disclosure. R.L.: Nothing to disclosure. F.P.: Nothing to disclosure. R.G.: Nothing to disclosure. B.J.W.C. receives research support from TD Bank and Artrya. He is a consultant for and has an equity interest in Artrya.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
Study population.
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