Abstract 12850: Derivation and External Validation of a High Sensitivity Troponin Based Proteomic Model to Predict the Presence of Obstructive Coronary Artery Disease

IntroductionCurrent non-invasive modalities utilized to diagnose obstructive coronary artery disease (CAD) are limited by variable sensitivity and specificity, the need for ionizing radiation or contrast, and cost. Concentrations of high sensitivity cardiac troponin (hs-cTn) are associated with pres...

Full description

Saved in:
Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A12850-A12850
Main Authors: McCarthy, Cian P, Neumann, Johannes T, Michelhaugh, Sam A, Ibrahim, Nasrien E, Gaggin, Hanna K, Sörensen, Nils A, Magaret, Craig A, Barnes, Grady, Rhyne, Rhonda F, Westermann, Dirk, Januzzi, James L
Format: Article
Language:English
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:IntroductionCurrent non-invasive modalities utilized to diagnose obstructive coronary artery disease (CAD) are limited by variable sensitivity and specificity, the need for ionizing radiation or contrast, and cost. Concentrations of high sensitivity cardiac troponin (hs-cTn) are associated with presence of obstructive CAD but are poorly specific.HypothesisA combination of clinical risk factors and biomarkers may offer an attractive alternative diagnostic strategy for obstructive CAD.MethodsIn a derivation cohort of 636 patients referred for coronary angiography, predictors of ≥70% stenosis in at least 1 major coronary vessel were identified from six clinical variables and 109 biomarkers. The final model was first internally validated on a separate cohort (n=275) and then externally validated on a cohort of 241 patients presenting to the ED with suspicion for acute MI where ≥ 50% stenosis in at least one coronary artery was considered significant.ResultsThe resulting model (HART CADhs) consisted of three clinical variables (male sex, age, and previous percutaneous coronary intervention) and 3 biomarkers (hs-cTnI, adiponectin, and kidney injury molecule-1). In the internal validation cohort, the system had an area under the receiver-operating characteristic curve (AUC) of 0.85 for coronary stenosis ≥70% (p
ISSN:0009-7322
1524-4539
DOI:10.1161/circ.140.suppl_1.12850