Relationship between the Castelli risk indeces and the presence and severity of ischemia in non-geriatric patients with suspected coronary artery disease

Year 2023, , 128 - 136, 23.03.2023

Birsen Doğanay

https://doi.org/10.18663/tjcl.1252801

Abstract

Aims: This study aimed to investigate the relationship between ischemia severity and Castelli risk indices (CRI) levels in non-geriatric patients with suspected coronary artery disease (CAD) referred to myocardial perfusion scintigraphy (MPS) with gated single photon emission computed tomography (SPECT).
Material and Methods: This retrospective study included 417 non-geriatric patients referred to SPECT MPS for suspected CAD at the Cardiology Clinic between January 2019 and January 2021. Patients were divided into normal, mild, moderate, and severe ischemia groups according to MPS. CRIs were calculated as follows: CRI-I = total cholesterol / HDL ratio; CRI-II = LDL / HDL ratio.
Results: The CRIs levels were higher in ischemia group than non-ischemia group. Increase in CRI-II level was associated with increased ischemia severity. Increased CRI-II level was found to be an independent predictor of mild, moderate and severe ischemia group, but CRI-I was similar in moderate and severe ischemia groups. The threshold value of CRI-II for predicting the presence of ischemia was >2.1 (AUC ± SE = 0.787 ± 0.02, sensitivity = 79.5%, specificity = 71.4%). The threshold values of CRI-II showed a gradual increase in predicting the severity of ischemia.
Conclusion: CRI-II offers offers gradually increasing threshold values in distinguishing patients with suspected CAD but without perfusion defects or determining its severity in the case of ischemia. CRI-II can be a potential screening tool for patients with suspected CAD and it can be used for risk stratification.

Keywords

Castelli risk index, coronary artery disease, ischemia, lipids

Supporting Institution

No

Koroner arter hastalığı şüphesi olan non-geriatrik hastalarda Castelli risk indeksleri ile iskeminin varlığı ve şiddeti arasındaki ilişki

Abstract

Amaç: Bu çalışmada, kapılı tek foton emisyonlu bilgisayarlı tomografi (SPECT) ile miyokardiyal perfüzyon sintigrafisine (MPS) yönlendirilen koroner arter hastalığı (KAH) şüphesi olan non-geriatrik hastalarda iskemi şiddeti ile Castelli risk indeksleri (CRI) arasındaki ilişkinin araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Bu retrospektif çalışmaya Ocak 2019 ile Ocak 2021 arasında Kardiyoloji Kliniğinde KAH şüphesi nedeniyle SPECT MPS'ye yönlendirilen 417 non-geriatrik hastayı dahil edildi. Hastalar MPS'ye göre normal, hafif, orta ve ağır iskemi gruplarına ayrıldı. CRI düzeyleri CRI-I = toplam kolesterol / HDL oranı; CRI-II = LDL / HDL oranı olarak hesaplandı.
Bulgular: CRI seviyeleri iskemi grubunda iskemisi olmayan gruba göre daha yüksekti. CRI-II seviyesindeki artış, artan iskemi şiddeti ile ilişkili saptandı. Artmış CRI-II düzeyi, hafif, orta ve ağır iskemi grubu için bağımsız bir belirteç olarak bulundu, ancak CRI-I, orta ve ağır iskemi gruplarında benzerdi. CRI-II'nin iskemi varlığını öngörme eşik değeri >2,1'dir (AUC ± SE = 0,787 ± 0,02; duyarlılık = %79,5; özgüllük = %71,4). İskeminin ciddiyetini öngörmede CRI-II’nin eşik değerleri kademeli bir artış gösterdi.
Sonuçlar: CRI-II, KAH şüphesi olan ancak perfüzyon kusurları veya normal koroner arterleri olmayan hastaları ayırt etmede ve iskemi ciddiyetini belirlemede kademeli artan eşik değerler sunar. Bu nedenle, CRI-II KAH şüphesi olan hastalar için potansiyel bir tarama aracı olabilir ve risk sınıflandırması için kullanılabilir.

Keywords

Castelli risk indeksi, iskemi, koroner arter hastalığı, lipid, Castelli risk index, coronary artery disease, ischemia, lipids

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