December 16, 2005Arteriosclerosis Thrombosis and Vascular Biology

A Negative Carotid Plaque Area Test Is Superior to Other Noninvasive Atherosclerosis Studies for Reducing the Likelihood of Having Underlying Significant Coronary Artery Disease

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Coronary artery disease (n=42). Intervention: Carotid plaque area (CPA) vs. Coronary calcium score (CCS), intima-media thickness (IMT), and C-reactive protein (CRP). Primary outcome: Presence of clinically significant coronary artery disease (CAD) defined as any stenosis ≥50% (LR 0.48).

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Key result

A negative carotid plaque area test (CPA=0) yielded a superior negative predictive value (74% vs 65%) and likelihood ratio (0.48 vs 0.72) compared to a coronary calcium score of 0 for detecting CAD.

Why the study?

Does carotid plaque area measurement improve the detection of clinically significant coronary artery disease compared to coronary calcium score, intima-media thickness, and C-reactive protein in patients undergoing coronary CTA?

Population

42 patients who had a 16-slice coronary computed tomography angiogram (CTA) performed

Comparison

Carotid plaque area (CPA) measurement vs Coronary calcium score, carotid intima-media…

Design

Cross-sectional

Authors

RBRobert D. BrookPreventive Cardiology RBRobert L. BardMichigan Medicine SPSmita PatelUniversity of Michigan

Discussion

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Implication

Negative CPA may aid CAD rule-out versus CCS=0 on CTA; leaves open prospective validation in larger cohorts.

Key Points

This research aims to compare the effectiveness of carotid plaque area, coronary calcium score, intima-media thickness, and C-reactive protein in screening for significant coronary artery disease.
Measured carotid plaque area, intima-media thickness, and C-reactive protein in 42 patients after coronary computed tomography angiogram.
Clerared clinically significant coronary artery disease as any stenosis ≥50%.
Compared sensitivities and specificities of CPA, CCS, IMT, and CRP for identifying CAD.
CPA demonstrated 72% sensitivity and 58% specificity for identifying CAD, whereas CCS showed 58% sensitivity and 55% specificity.
A clean carotid artery (CPA=0) had a negative predictive value of 74% and likelihood ratio of 0.48, superior to CCS.
In patients with negative CPA results, the post-test probability for CAD drops to 10%.

Study Design

Type

Cross-Sectional (n=42)

Structured PICO

Population

42 patients who had a 16-slice coronary computed tomography angiogram (CTA) performed

Intervention

Carotid plaque area (CPA) measurement

Comparator

Coronary calcium score (CCS), carotid intima-media thickness (IMT), and C-reactive protein (CRP)

Outcome

Presence of clinically significant coronary artery disease (CAD) defined as any stenosis ≥50% on CTAsurrogate

Main Result

Effect estimate: LR 0.48

Absolute Event Rate: 74% vs 65%

Carotid plaque area measurement may be superior to coronary calcium score, IMT, and CRP for ruling out clinically significant coronary artery disease.

Cite This Study

Brook et al. (2005) conducted a cross-sectional in Coronary artery disease (n=42). Carotid plaque area (CPA) vs. Coronary calcium score (CCS), intima-media thickness (IMT), and C-reactive protein (CRP) was evaluated on Presence of clinically significant coronary artery disease (CAD) defined as any stenosis ≥50% (LR 0.48). A negative carotid plaque area test (CPA=0) yielded a superior negative predictive value (74% vs 65%) and likelihood ratio (0.48 vs 0.72) compared to a coronary calcium score of 0 for detecting CAD.

synapsesocial.com/papers/6a0661179fae39ec6e2af3ca https://doi.org/10.1161/01.atv.0000200079.18690.60

Topics

Coronary artery disease Coronary CT angiography

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A Negative Carotid Plaque Area Test Is Superior to Other Noninvasive Atherosclerosis Studies for Reducing the Likelihood of Having Underlying Significant Coronary Artery Disease

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

A Negative Carotid Plaque Area Test Is Superior to Other Noninvasive Atherosclerosis Studies for Reducing the Likelihood of Having Underlying Significant Coronary Artery Disease

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider