Validation of the European Society of Cardiology pretest probability models for obstructive coronary artery disease in high-risk population

• Published in: Hellenic journal of cardiology 2024-05
• Main Authors: Vranic, Ivona, Stankovic, Ivan, Ignjatovic, Aleksandra, Kafedzic, Srdjan, Radovanovic-Radosavljevic, Mina, Neskovic, Aleksandar N., Vidakovic, Radosav
• Format: Article
• Language: English
• Subjects: Chronic coronary syndrome; Coronary artery disease; Pre-test probability
• ISSN: 1109-9666; 2241-5955; 2241-5955
• DOI: 10.1016/j.hjc.2024.05.003

The pre-test probability (PTP) model for obstructive coronary artery disease (CAD) was updated in 2019 by the European Society of Cardiology (ESC). To our knowledge, this model was never externally validated in a population with a high incidence of CAD. The aim of this study is to validate the new PTP ESC model in our population, which has a high CAD incidence, and to compare it with the previous PTP ESC model from 2013. We retrospectively analysed 1294 symptomatic patients with suspected CAD referred to our centre between 2015 and 2019. In all patients, the PTP score was calculated based on age, gender, and symptoms according to the ESC model from 2013 (2013-ESC-PTP) and 2019 (2019-ESC-PTP). All patients underwent invasive coronary angiography (ICA). Of the 1294 patients, obstructive CAD was diagnosed in 533 patients (41.2%). The 2019-ESC-PTP model categorised significantly more patients into the low probability group (PTP < 15%) than the 2013-ESC-PTP model (39.8% vs. 5.6%, p