* Corresponding Author
Addition of Risk Factors of Coronary Heart Disease in Diagnostic Value of Treadmill Score for Detecting Complexity of Coronary Arterial Lesions
https://doi.org/10.22146/aci.40853 Mariyetty K.S. Nasution(1*), Abdullah A. Siregar(2), Harris Hasan(3), Zulfikri Mukhtar(4), Abdul H. Raynaldo(5), Nizam Akbar(6)
(1) Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Sumatera Utara, Adam Malik Hospital, Medan, North Sumatera
(2) Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Sumatera Utara, Adam Malik Hospital, Medan, North Sumatera
(3) Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Sumatera Utara, Adam Malik Hospital, Medan, North Sumatera
(4) Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Sumatera Utara, Adam Malik Hospital, Medan, North Sumatera
(5) Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Sumatera Utara, Adam Malik Hospital, Medan, North Sumatera
(6) Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Sumatera Utara, Adam Malik Hospital, Medan, North Sumatera
(*) Corresponding Author
Abstract
Background: Coronary heart disease (CHD) is still the leading cause of death in the world. There are various risk factors for atherosclerosis leading to CHD. Duke Treadmill Score (DTS) is known to demonstrate prognostic stratification and has a diagnostic value in predicting the number of coronary arteries involved in patient populations with ischemic heart disease. However, DTS does not describe the role of risk factors for coronary heart disease to the complexity of coronary artery lesions. This study aims to add risk factors for coronary heart disease on DTS to detect the complexity of coronary artery lesions with stable angina pectoris.
Methods: This study was a cross-sectional study in stable angina pectoris patient who comes to Haji Adam Malik Hospital Medan from January 2017 until February 2018. Patients who have done treadmill test and coronary angiography, and fulfill inclusion and exclusion criteria are included in the study. ECG examination and recording of risk factors for coronary heart disease were done. DTS assessment was performed based on a treadmill test and Syntax score based on coronary angiography results. Diagnostic tests were performed to assess the sensitivity and specificity of the addition of CHD risk factors to detect the complexity of coronary artery lesions.
Results: Of the 76 people with stable angina pectoris, 55 people were found with low SYNTAX and 21 people with high Syntax. DTS is divided into 3 groups: mild (> -10), moderate (-10 to - 13.5), and severe (≤-13.6) based on the cut off of the ROC curve. Risk factors for CHD are divided into 3 groups, mild (≤3 CHD risk factors), moderate (4-6 CHD risk factors), and severe (7 CHD risk factors) based on the cut off of the ROC curve, then assessed the relationship with Syntax which has been divided into 2 groups, low Syntax, and high Syntax. Diagnostic test shows the addition of risk factors of CHD to DTS to detect the complexity of coronary artery lesions have greater sensitivity and specificity than DTS without the addition of risk factors of CHD, 95%, and 89%.
Conclusion: The addition of risk factors for coronary heart disease on DTS can detect the complexity of coronary artery lesions.
Keywords
Full Text:
PDFReferences
Wilder J., Sabatine M.S., Lilly L.S. 2016. Ischemic Heart Disease Chapter 6.In: Lilly, Leonard S. Pathophysiology of heart disease: a collaborative project of medical students and faculty. 6th ed. Baltimore: Lippincott Williams & Wilkins, pp.134-161.
Haris H., Elvrida D. 2016. Angina Pektoris Stabil (APS). In: Kasiman (eds)Nyeri dada dari A sampai Z. Medan: Pustaka Bangsa, pp. 10-40.
Lilly L.S. 2012. Pathophysiology of heart disease: a collaborative project of medical students and faculty. 6th ed.Baltimore: Lippincott Williams & Wilkins.
Tardif C.J. 2010. Coronary artery disease in 2010. Eur Heart J Supplement, 12 (Supplement C), C2–C10.
Gibbons R.J., Balady G.J., Bricker J.T., Chaitman B.R., Fletcher G.F., Froelicher V.F., et al. ACC/AHA 2002 Guideline update for exercise testing. American College of Cardiology Foundation and American Heart Association. J Am Coll Cardiol, 40:1531-1540.
Mark D.B., Hlatky M.A., Harrell F.E.Jr., Lee K.L., Califf R.M., Pryor D.B. 1987. Exercise treadmill score for predicting prognosis in coronary artery disease.Ann Intern Med, 106:793-800.
Mohr F.W., Morice M.C., Kappetein A.P., Feldman T.E., Ståhle E., Colombo A., et al. 2013. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5- years follow up of the randomized, clinical SYNTAX Trial. Lancet, 381:629-638.
Acar Z., Korkmaz L., Agac M.T., Erkan H., Dursun I., Kalaycioglu E., et al. 2012. Relationship between Duke treadmill score and coronary artery lesion complexity. Clin Invest Med, 35:E365-369.
Günaydın Z.Y., Bektaş O., Gürel Y.E., Karagöz A., Kaya A., Kırış T., et al. 2016. The value of the Duke treadmill score in predicting the presence and severity of coronary artery disease. Kardiol Pol, 74:127-134.
Perhimpunan Dokter Spesialis Kardiologi Indonesia. 2016. Pedoman Uji Latih Jantung: Prosedur dan Interpretasi. Jakarta: PERKI.
Dahlan M.S. 2009. Penelitian Diagnostik. Edisi ketiga. Jakarta: Penerbit Salemba Medika.
Cheng V.Y., Berman D.S., Rozanski A., Dunning A.M., Achenbach S., AlMallah M., et al. 2011. Performance of the traditional age, sex, and angina typicality–based approach for estimating pretest probability of angiographically significant coronary artery disease in patients undergoing coronary computed tomographic angiography. Circulation, 124:2423- 2432.
Mayasari N.M.E, Arso I.A., Maharani E. 2016. Nilai diagnostik Duke treadmill score untuk mendeteksi keparahan lesi arteri koroner pada pasien yang terduga penyakit jantung koroner stabil. J Kardiol Indones,37:65-74
Shahawy S., Libby P. 2016. Atherosclerotic. In: Lilly, Leonard S. Pathophysiology of heart disease: a collaborative project of medical students and faculty. 6th ed. Baltimore: Lippincott Williams & Wilkins, pp. 112- 133.
Alvarez-Tamargo J.A., Simarro MartínAmbrosio E., Romero-Tarín E., Albadalejo-Salinas V.J., de la Hera J.M., Martín-Fernández M., et al. 2005. Angiographic evaluation of high risk treadmill score in patient with stable angina according to sex, age, or use of drugs with negative chronotropic effect. Rev Esp Cardiol, 59:448-457.
DOI: https://doi.org/10.22146/aci.40853
Article Metrics
Abstract views : 1568
| 
views : 1433
Refbacks
- There are currently no refbacks.
Copyright (c) 2018 Mariyetty K.S. Nasution, Abdullah A. Siregar, Harris Hasan, Zulfikri Mukhtar, Abdul H. Raynaldo, Nizam Akbar
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
ACI (Acta Cardiologia Indonesiana) is indexed by:
ACI (Acta Cardiologia Indonesiana) is published by:
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Address: Radiopoetro Building 2nd Floor, West Wing, Farmako Street, Sekip, Yogyakarta, Indonesia 55281
ACI (Acta Cardiologia Indonesiana) is endorsed by:
