USEFULNESS OF CINEFLUOROSCOPIC DETECTION OF CORONARY-ARTERY CALCIFICATION IN THE DIAGNOSTIC WORK-UP OF CORONARY-ARTERY DISEASE

Aim: To determine in which patients (cine)fluoroscopic detection of co ronary artery calcifications is recommended for the diagnosis of coron ary artery disease and the consequence of this finding for referral fo r cinecoronary arteriography. Materials and methods: Data were retrosp ectively obtained from 778 patients who had been referred for cinecoro nary arteriography. Excluded were patients with a previous myocardial infarction, a previous abnormal cinecoronary arteriogram and patients with unstable angina. The discriminating value was assessed with the h elp of the crude likelihood ratio (LR), as well as the LRs stratified for gender, age and symptomatology. The gold standard was the coronary arteriogram. Furthermore, the post-test probability was estimated usi ng logistic regression to take dependence on age, sex and symptomatolo gy into account. Results: The crude LR of a positive and negative test result, with 95% confidence intervals, was, respectively 5.8 (4.1-8.2 ) and 0.52 (0.47-0.58), but was dependent on the clinical variables. E stimated probabilities of having coronary artery disease (CAD) varied substantially for a negative as well as a positive test result with th e categories of clinical variables. Conclusion: (Cine)fluoroscopy disc riminates between patients with and without disease; the test proved t o be especially useful in females with atypical angina and patients of both sexes with non-specific chest pain.