Does the RF-CL model improve the diagnosis of obstructive CAD compared to the traditional Diamond-Forrester model in patients with suspected chronic coronary syndrome?
The new risk factor-weighted clinical likelihood model did not demonstrate any diagnostic advantages over the traditional Diamond-Forrester model for identifying obstructive CAD in patients with suspected chronic coronary syndrome.
Objective. To identify gender differences using a new clinical probability model for chronic coronary syndrome (CCS) based on risk factor-weighted clinical likelihood (RF-CL) and traditional Diamond-Forrester CAD pre-test probability model (PTP DF model). Material and methods. The registry study included 144 men (mean age 64.7±10.2 years) and 93 women (mean age 67.3±9.4 years) who were examined for suspected CCS. Diagnosis of CAD was carried out in accordance with current (2024) Russian guidelines «Stable coronary artery disease» 6. Additionally, we calculated clinical probability of obstructive CAD using the RF-CL model. Results. Clinical likelihood of CCS based on new RF-CL model was higher in men (17% vs. 7%; p0.05). According to clinical data and stress testing, 45 (31%) men and 7 (7%) women were referred for invasive coronary angiography (ICA). When comparing the probabilities of obstructive CAD based on RF-CL and PTP DF model with ICA data, we obtained no significant differences between new and traditional models (p>0.05). Conclusion. In our cohort of patients, the RF-CL clinical probability model did not demonstrate any advantages over traditional DF model of coronary artery disease in men and women.
Nurutdinov et al. (Wed,) studied this question.
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