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Utility of Systematic Coronary Risk Evaluation (SCORE) system to predict coronary artery disease severity in low to moderate risk hypertensive patients undergoing elective coronary angiography
Affiliations- Department of Cardiology, Gaziosmanpasa University, School of Medicine, Tokat, Türkiye
open access
Abstract
Background: Coronary artery disease (CAD) is the leading cause of mortality in hypertensive patients. Systematic Coronary Risk Evaluation (SCORE) is the preferred scoring system to predict future fatal cardiovascular events in hypertensive patients. However, the relationship between SCORE and coronary atherosclerosis is not well described. We aimed to investigate whether SCORE has a relationship with CAD severity in hypertensive patients, even in the absence of high risk features.
Material and methods: Four hundred and fifty-two hypertensive patients who underwent elective coronary angiography and defined as low or moderate risk according to SCORE were included into the study. Patients were divided into two groups. Patients with a SCORE < 1% were defined as low risk group, and patients with a SCORE ≥ 1% and < 5% were defined as moderate risk group. The groups were compared regarding CAD severity.
Results: The frequency of stenotic CAD and multivessel disease, and mean SYNTAX score, were significantly higher in SCORE ≥ 1%, and < 5% group compared to patients with SCORE < 1%. Correlation analysis revealed a significant positive moderate correlation between SCORE and SYNTAX score (Pearson’s r: 0.679, p < 0.001). ROC curve analysis demonstrated that a SCORE ≥ 3% predicted SYNTAX score > 22 with a sensitivity of 75% and a specificity of 86.5% (AUC: 0.879, p < 0.001). Furthermore, multivariate analysis demonstrated that SCORE was an independent predictor of stenotic CAD (OR: 1.616, p < 0.001), multivessel disease (OR: 1.913, p < 0.001), and SYNTAX score > 22. (OR: 1.817, p < 0.001).
Conclusion: Our results suggest that SCORE is associated with CAD severity in hypertensive patients even in the
absence of high risk features. The SCORE system may be useful in further risk stratification of hypertensive patients
with moderate risk features and suspected CAD.
Abstract
Background: Coronary artery disease (CAD) is the leading cause of mortality in hypertensive patients. Systematic Coronary Risk Evaluation (SCORE) is the preferred scoring system to predict future fatal cardiovascular events in hypertensive patients. However, the relationship between SCORE and coronary atherosclerosis is not well described. We aimed to investigate whether SCORE has a relationship with CAD severity in hypertensive patients, even in the absence of high risk features.
Material and methods: Four hundred and fifty-two hypertensive patients who underwent elective coronary angiography and defined as low or moderate risk according to SCORE were included into the study. Patients were divided into two groups. Patients with a SCORE < 1% were defined as low risk group, and patients with a SCORE ≥ 1% and < 5% were defined as moderate risk group. The groups were compared regarding CAD severity.
Results: The frequency of stenotic CAD and multivessel disease, and mean SYNTAX score, were significantly higher in SCORE ≥ 1%, and < 5% group compared to patients with SCORE < 1%. Correlation analysis revealed a significant positive moderate correlation between SCORE and SYNTAX score (Pearson’s r: 0.679, p < 0.001). ROC curve analysis demonstrated that a SCORE ≥ 3% predicted SYNTAX score > 22 with a sensitivity of 75% and a specificity of 86.5% (AUC: 0.879, p < 0.001). Furthermore, multivariate analysis demonstrated that SCORE was an independent predictor of stenotic CAD (OR: 1.616, p < 0.001), multivessel disease (OR: 1.913, p < 0.001), and SYNTAX score > 22. (OR: 1.817, p < 0.001).
Conclusion: Our results suggest that SCORE is associated with CAD severity in hypertensive patients even in the
absence of high risk features. The SCORE system may be useful in further risk stratification of hypertensive patients
with moderate risk features and suspected CAD.
Keywords
hypertension; coronary artery disease; coronary angiography; SCORE; SYNTAX score
About this articleTitle
Utility of Systematic Coronary Risk Evaluation (SCORE) system to predict coronary artery disease severity in low to moderate risk hypertensive patients undergoing elective coronary angiography
Journal
Issue
Article type
Original paper
Pages
128-134
Published online
2020-09-17
Page views
830
Article views/downloads
2508
DOI
Bibliographic record
Arterial Hypertension 2020;24(3):128-134.
Keywords
hypertension
coronary artery disease
coronary angiography
SCORE
SYNTAX score
Authors
Mehmet Eyuboglu
Metin Karayakalı
Kayihan Karaman
Arif Arısoy
Atac Celık
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