Key result
Elevated ACEF score linked to ~5.6-fold higher odds of severe coronary stenosis on CTA.
Why the study?
The ACEF risk score predicts mortality and major adverse cardiovascular events, but its relationship with the degree of coronary artery stenosis needed investigation.
Does the ACEF risk score predict severe coronary artery stenosis in patients with chronic coronary syndrome?
Observational (n=148)
No
Does the ACEF risk score predict severe coronary artery stenosis in patients with chronic coronary syndrome?
The simple ACEF risk score can help predict the presence of severe coronary stenosis on CTA, potentially aiding in better risk stratification and appropriate referral for invasive angiography.
ACEF score may aid noninvasive stratification in chronic coronary syndrome; leaves open prospective validation before guiding angiography decisions.
BACKGROUND: The ACEF risk score (age, creatinine, and ejection fraction) has been associated with satisfactory predictive values not only for short-term and long-term mortality but also for major adverse cardiovascular events. OBJECTIVES: Investigate the relationship between ACEF risk score and degree of coronary artery stenosis. DESIGN: Retrospective, observational study. SETTING: Tertiary percutaneous coronary intervention center. PATIENTS AND METHODS: In patients with coronary coronary artery stenosis <70% were compared with patients with stenosis ≥70%. All were diagnosed with chronic coronary syndrome (CCS) and had undergone coronary computed tomography angiography (CTA). Receiver operating characteristic analysis was performed for the cut-off value of the ACEF risk score. Univariable and multivariable regression analyses were performed for significant parameters related to degree of coronary artery stenosis in coronary CTA. MAIN OUTCOME MEASURES: Relationship between ACEF risk score and degree of coronary artery stenosis in coronary CTA. SAMPLE SIZE: 148 patients. RESULTS: In the multivariable regression analysis; left ventricular ejection fraction (OR: 0.94; 95%CI: 0.89-0.99, P =.015) and ACEF risk score (OR: 5.63; 95% CI: 1.62-19.57, P =.007) were independent predictors for degree of coronary artery stenosis. The ACEF risk score was statistically significantly higher in with patients with stenosis ≥70% (1.43 [0.59]) than in patients with stenosis <70% (0.98 [0.35]), P <.001). An ACEF risk score value >1.04 was a predictor of the presence of severe coronary artery stenosis detected by coronary CTA in patients with CCS, with 66% sensitivity and 69% specificity. CONCLUSIONS: A high ACEF risk score (age, creatinine, ejection fraction) in patients with CCS is associated with the presence of severe coronary artery stenosis detected by coronary CTA, and was useful as an assessment tool for coronary angiography in patients with CCS. LIMITATIONS: Since we do not have long-term follow-up results, we do not know the prognostic value of the ACEF risk score in the long-term follow-up of patients with CCS.
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Kış et al. (2023) conducted an observational in Chronic coronary syndrome (n=148). ACEF risk score was evaluated on Severe coronary artery stenosis (≥70%) detected by coronary CTA (OR 5.63, 95% CI 1.62-19.57, p=0.007). An elevated ACEF risk score was an independent predictor of severe coronary artery stenosis (≥70%) detected by computed tomography angiography (OR 5.63).
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