Prediction of coronary artery disease by a systemic atherosclerosis score index derived from whole-body MR angiography
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Prediction of coronary artery disease by a systemic atherosclerosis score index derived from whole-body MR angiography Stephanie Lehrke*, Benjamin Egenlauf, Henning Steen, Dirk Lossnitzer, Grigorius Korosoglou, Constanze Merten, Boris T Ivandic, Evangelos Giannitsis and Hugo A Katus Address: Abteilung Innere Medizin III, Medizinische Klinik, Universitätsklinikum Heidelberg, Heidelberg, Germany Email: Stephanie Lehrke* - [email protected]; Benjamin Egenlauf - [email protected]; Henning Steen - [email protected]; Dirk Lossnitzer - [email protected]; Grigorius Korosoglou - [email protected]; Constanze Merten - [email protected]; Boris T Ivandic - [email protected]; Evangelos Giannitsis - [email protected]; Hugo A Katus - [email protected] * Corresponding author
Published: 17 September 2009 Journal of Cardiovascular Magnetic Resonance 2009, 11:36
doi:10.1186/1532-429X-11-36
Received: 24 May 2009 Accepted: 17 September 2009
This article is available from: http://www.jcmr-online.com/content/11/1/36 © 2009 Lehrke et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Whole-body magnetic resonance angiography (WB-MRA) has shown its potential for the noninvasive assessment of nearly the entire arterial vasculature within one examination. Since the presence of extracardiac atherosclerosis is associated with an increased risk of coronary events, our goal was to establish the relationship between WB-MRA findings, including a systemic atherosclerosis score index, and the presence of significant coronary artery disease (CAD). Methods: WB-MRA was performed on a 1.5T scanner in 50 patients scheduled to undergo elective cardiac catheterization for suspected CAD. In each patient, 40 extra-cardiac vessel segments were evaluated and assigned scores according to their luminal narrowing. The atherosclerosis score index (ASI) was generated as the ratio of summed scores to analyzable segments. Results: ASI was higher in patients with significant (> 50% stenosis) CAD (n = 27) vs. patients without CAD (n = 22; 1.56 vs. 1.28, p = 0.004). ASI correlated with PROCAM (R = 0.57, p < 0.001) and Framingham (R = 0.36, p = 0.01) risk scores as estimates of the 10-year risk of coronary events. A ROC derived ASI of > 1.54 predicted significant CAD with a sensitivity of 59%, specificity of 86% and a positive predictive value of 84%. Logistic regression revealed ASI > 1.54 as the strongest independent predictor for CAD with a 11-fold increase in likelihood to suffer from significant coronary disease. On the contrary, while 15/27 (55%) of patients with CAD exh
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