COAL PREPARATION
Original Paper
UDC 616.127-005.4-07 © A.V. Shcheglova, A.N. Sumin, P.A. Oleinik, T.A. Kurbangaleeva, M.A. Petrova, V.V. Kashtalap, O.L. Barbarash, 2023
ISSN 0041-5790 (Print) • ISSN 2412-8333 (Online) • Ugol’ – Russian Coal Journal, 2023, № S12, pp. 135-142 DOI: http://dx.doi.org/10.18796/0041-5790-2023-S12-135-142
Title
EFFECTIVENESS OF PRE-TEST AND CLINICAL PROBABILITY ASSESSMENT IN PATIENTS WITH SUSPECTED CORONARY HEART DISEASE IN REAL CLINICAL PRACTICE
Authors
Shcheglova A.V.1 , Sumin A.N.1 , Oleinik P.A. 1 , Kurbangaleeva T.A. 2 , Petrova M.A. 2 , Kashtalap V.V.1 , Barbarash O.L. 1
1 Federal State Budgetary Scientific Institution “Research Institute of Complex Problems of Cardiovascular Diseases”, Kemerovo, 650002, Russian Federation
2 Kemerovo State University”, Kemerovo, 650056, Russian Federation
Authors Information
ShcheglovaA.V., PhD (Medical), Researcher at the Laboratory of Comorbidity in Cardiovascular Diseases of the Department of Clinical Cardiology, e-mail: nura.karpovitch@yandex.ru
Sumin A.N., Doctor of Medical Sciences, Head of the Laboratory of Comorbidity in Cardiovascular Diseases of the Department of Clinical Cardiology, e-mail: an_sumin@mail.ru
OleinikP.A., PhD (Medical), Cardiologist, Laboratory Assistant of Comorbidity in Cardiovascular Diseases of the Department of Clinical Cardiology, e-mail: pavel.oleinik.1991@mail.ru
Kurbangaleeva T.A., 4rd year student of the Faculty of Medicine, e-mail: tanya_kur00@mail.ru
Petrova M.A., 4rd year student of the Faculty of Medicine, e-mail: petrovamasha1904@icloud.com
Kashtalap V.V., Doctor of Medical Sciences, Head of the Department of Clinical Cardiology, e-mail: v_kash@mail.ru
Barbarash O.L., Academician of the Russian Academy of Sciences, Director, e-mail: reception@kemcardio.ru
Abstract
Background. In real clinical practice, a significant number of patients with invasive coronary angiography (CAG) do not show significant damage to the coronary arteries (CA), which leads to financial losses for the healthcare system and exposes patients to unnecessary risk.
Objective: to evaluate the possibilities of pre-test probability (PTV) and clinical probability in patients with suspected coronary artery disease.
Methods. The study included 187 patients (86 male, 101 female) with an average age of 64.3 ± 9.2 years, who were admitted to the Institution Re? search Institute for Complex Issues of Cardiovascular Diseases to perform CAG. All patients were evaluated by PTV according to the ESC 2019 scale of clinical recommendations. In the case of intermediate values of PTV (5-15%), the clinical probability was evaluated on the RF-CL scale. Based on the criteria of each scale, patients were allocated: group I with low PTV (15%, n=109).
Results. According to the results of CAG, the absence of CA lesion was in all patients with low PTV, with intermediate PTV, unchanged CA was de? tected in 59 (86.8%) patients, with high PTV in 81 (74.3%) patients (p=0.035, for trend). The use of the RF-CL scale allowed 30% of patients with initial intermediate PTV to be assigned to the low PTV group. In the group with low PTV, 90.0% of patients had intact CA and 10.0% had CA stenosis 70% only in the group with intermediate PTV (p=0.041). The patient in the high PTV group had unchanged CA.
Conclusion. During CAG, the frequency of detection of obstructive CA le? sions was 14% in patients with suspected coronary artery disease and 7% among all examined patients. In the group with high PTV, the frequency of detection of obstructive coronary artery disease was significantly higher. The assessment of the clinical probability of coronary artery disease allows to reclassify an additional 30% of patients with initial intermediate PTV into the group with a low probability of obstructive coronary artery disease.
Keywords
Chronic coronary syndrome, Pre-test probability, Clinical probability, Coro? nary angiography, Real clinical practice, Diagnostic algorithm.
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Acknowledgements
The study was supported by the Russian Federation, specifically the Min? istry of Science and Higher Education of the Russian Federation, under the Agreement for providing grant funding in the form of subsidies from the federal budget, dated September 30, 2022, No 075-15-2022-1202. The study is a part of a comprehensive scientific and technological program of the full innovation cycle, entitled “Development and implementation of technologies in the fields of solid mineral exploration and extraction, industrial safety, bioremediation, and the creation of new products through deep coal processing, all with a gradual reduction of environmental impact and risks to the population`s well-being”. This initiative was established by the Russian Government`s decree No 1144-r on May 11, 2022.
For citation
Shcheglova A.V., Sumin A.N., Oleinik P.A., Kurbangaleeva T.A., Petrova M.A., Kashtalap V.V. & Barbarash O.L. Effectiveness of pre-test and clinical probability assessment in patients with suspected coronary heart disease in real clinical practice. Ugol’, 2023, (S12), pp. 135-142. (In Russ.). DOI: 10.18796/0041- 5790-2023-S12-135-142.
Paper info
Received November 1, 2023
Reviewed November 15, 2023
Accepted November 30, 2023
