Utilidad del score de calcio ecocardiográfico como herramienta predictiva de enfermedad coronaria obstructiva / Usefulness of the Echocardiographic Calcium Score as Predictive Tool for Obstructive Coronary Artery Disease:

RESUMEN

RESUMEN Objetivos: Evaluar el valor predictivo del score cálcico ecocardiográfico (SCE). Material y métodos: Se evaluaron 96 pacientes con indicación de coronariografía (CCG). Síndrome coronario sin supra ST 20 pacientes. Angina crónica 15 pacientes Síndrome coronario con supra ST 31 pacientes. Asintomáticos 30 pacientes. Se efectuó ecocardiograma con SCE y correlación con coronariopatía. Dos grupos pacientes con SCE ≤ 1 y SCE ≥ 2. Resultados: Sobre 96 pacientes, 23 sin lesiones con SCE 0,61, y 73 con lesión SCE 2,63. Entre aquellos con lesión, 16 lesión única SCE 1,68, 57 lesión múltiple SCE 2,87. De 23 sin lesiones 20 tuvieron SCE ≤ 1, y 3 SCE ≥ 2, y de 73 con lesiones 13 tuvieron SCE ≤ 1, y 60 SCE ≥ 2; así, un SCE ≥ 2 presenta mayor frecuencia de coronariopatía vs. SCE ≤ 1 (p < 0,05), sensibilidad 82,2%, especificidad 87%, valor predictivo positivo 95,2%, y negativo 60,6%. En lesión única vs. múltiple 16 presentaron lesión única, 9 tenían SCE ≥ 2, y 57 múltiple, 51 tenían SCE ≥ 2, sensibilidad 89,5% y especificidad 43,8% para identificar múltiples vasos, valor predictivo positivo 85%, y negativo 53,8%. Conclusiones: El SCE tendría buen valor predictivo positivo para coronariopatía.

ABSTRACT

ABSTRACT Objectives: The aim of this study was to evaluate the predictive value of the echocardiographic calcium score (ECS). Methods: Ninety-six patients with coronary angiography indication were enrolled in the study 20 with non-ST-segment elevation acute coronary syndrome, 15 with chronic angina, 31 with ST-segment elevation acute coronary syndrome and 30 asymptomatic patients. After echocardiography with ECS and correlation with coronary artery disease, patients were classified into 2 groups according to ECS ≤1 or ECS ≥2. Results: Among the total number of patients, 23 patients without lesions had ECS 0.61 and 73 with lesions had ECS 2.63. In patients presenting lesions, 16 had single lesion with ECS 1.68 and 57 multiple lesions with ECS 2.87. In the 23 patients without lesions, 20 had ECS ≤1 and 3 ECS ≥2, and among the 73 patients with lesions, 13 had ECS ≤1 and 60 ECS ≥2. Thus, ECS ≥2 presented a higher frequency of coronary artery disease vs. ECS ≤1 (p <0.05), with 82.2% sensitivity, 87% specificity, 95.2% positive predictive value and 60.6% negative predictive value. In single vs. multiple lesions, 9 out of 16 patients with single lesion had ECS ≥2 and 51 out of 57 patients with multiple lesions had ECS ≥2, with 89.5% sensitivity and 43.8% specificity to identify multivessel disease, and 85% positive predictive value and 53.8% negative predictive value. Conclusions: The ECS would have good positive predictive value to assess coronary artery disease.