Abstract 15761: Risk-Reclassification of Patients With Suspected Coronary Artery Disease Using an Acoustic Score

• Published in: Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A15761-A15761
• Main Authors: Schmidt, Samuel E, Winther, Simon, Grønhøj, Mette H, Nissen, Louise, Larsen, Bjarke S, Westra, Jelmer S, Holm, Niels R, Frost, Lars, Boetker, Hans Erik, Diederichsen, Axel, Struijk, Johannes J, Boettcher, Morten H
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

BackgroundConventional risk stratification for suspected coronary artery disease (CAD) results in a low proportion of positive findings in patients referred to non-invasive tests. The novel stethoscopic device (CADscor©), uses advanced analysis of sounds from the coronary circulation and myocardium in combination with age, gender and blood pressure to detect CAD. In the current database study, recordings of heart sounds were processed using the CAD-score algorithm to validate the rule-out potential of a re-classification scheme combining the CAD-score and the Diamond-Forrester score.MethodsThe database included audio recordings from 2373 patients (female53%, mean age 58.3±8.4 years) from three studiesthe Dan-NICAD study in symptomatic patients referred for coronary CTA (n= 1525), a cohort of asymptomatic subjects undergoing calcium scoring in the Dan-Risk study (n= 622) and a study including symptomatic patients referred for either coronary CTA or coronary angiography (CAG) (n= 226). Patients whose CTA or calcium score indicated CAD were referred to CAG. CAD was defined as ≥50% diameter stenosis confirmed by CAG. Pre-test risk was calculated using the updated Diamond-Forrester and patients were classified according to the current ESC guideline for stable anginalow risk 85%. Patients in the intermediate risk group were re-classified to low risk if the CAD-score was below or equal to 20 out of 100.ResultsThe CAD-score could be calculated in 2237 (94.3%) of the audio recordings, of these 212 (9.5%) patients tested positive for obstructive CAD. The CAD-score was significantly higher in confirmed CAD patients 38.4 (SD13.9) versus 25.1 (SD13.8) in remaining patients (p