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Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score

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Harvard

Hasselbalch, RB, Pries-Heje, MM, Kjølhede Holle, SL, Engstrøm, T, Heitmann, M, Pedersen, F, Schou, M, Mickley, H, Elming, H, Steffensen, R, Koeber, L & Iversen, K 2020, 'Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score', Open Heart, bind 7, nr. 2, e001380. https://doi.org/10.1136/openhrt-2020-001380

APA

Hasselbalch, R. B., Pries-Heje, M. M., Kjølhede Holle, S. L., Engstrøm, T., Heitmann, M., Pedersen, F., Schou, M., Mickley, H., Elming, H., Steffensen, R., Koeber, L., & Iversen, K. (2020). Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score. Open Heart, 7(2), [e001380]. https://doi.org/10.1136/openhrt-2020-001380

CBE

Hasselbalch RB, Pries-Heje MM, Kjølhede Holle SL, Engstrøm T, Heitmann M, Pedersen F, Schou M, Mickley H, Elming H, Steffensen R, Koeber L, Iversen K. 2020. Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score. Open Heart. 7(2):Article e001380. https://doi.org/10.1136/openhrt-2020-001380

MLA

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Author

Hasselbalch, Rasmus Bo ; Pries-Heje, Mia Marie ; Kjølhede Holle, Sarah Louise ; Engstrøm, Thomas ; Heitmann, Merete ; Pedersen, Frants ; Schou, Morten ; Mickley, Hans ; Elming, Hanne ; Steffensen, Rolf ; Koeber, Lars ; Iversen, Kasper. / Coronary risk of patients with valvular heart disease : prospective validation of CT-Valve Score. I: Open Heart. 2020 ; Bind 7, Nr. 2.

Bibtex

@article{b3bdf99ac3e74368a2adc4146f00fa6a,
title = "Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score",
abstract = "OBJECTIVE: To prospectively validate the CT-Valve score, a new risk score designed to identify patients with valvular heart disease at a low risk of coronary artery disease (CAD) who could benefit from multislice CT (MSCT) first instead of coronary angiography (CAG).METHODS: This was a prospective cohort study of patients referred for valve surgery in the Capital Region of Denmark and Odense University Hospital from the 1 February 2015 to the 1 February 2017. MSCT was implemented for patients with a CT-Valve score ≤7 at the referring physician's discretion. Patients with a history of CAD or chronic kidney disease were excluded. The primary outcome was the proportion of patients needing reevaluation with CAG after MSCT and risk of CAD among the patients determined to be low to intermediate risk.RESULTS: In total, 1149 patients were included. The median score was 9 (IQR 3) and 339 (30%) had a score ≤7. MSCT was used for 117 patients. Of these 29 (25%) were reevaluated and 9 (7.7%) had CAD. Of the 222 patients with a score ≤7 that did not receive an MSCT, 14 (6%) had significant CAD. The estimated total cost of evaluation among patients with a score ≤7 before implementation was €132 093 compared with €79 073 after, a 40% reduction. Similarly, estimated total radiation before and after was 608 mSv and 362 mSv, a 41% reduction. Follow-up at a median of 32 months (18-48) showed no ischaemic events for patients receiving only MSCT.CONCLUSION: The CT-Valve score is a valid method for determining risk of CAD among patients with valvular heart disease. Using a score ≤7 as a cut-off for the use of MSCT is safe and cost-effective.",
keywords = "coronary artery disease, risk stratification, valvular disease",
author = "Hasselbalch, {Rasmus Bo} and Pries-Heje, {Mia Marie} and {Kj{\o}lhede Holle}, {Sarah Louise} and Thomas Engstr{\o}m and Merete Heitmann and Frants Pedersen and Morten Schou and Hans Mickley and Hanne Elming and Rolf Steffensen and Lars Koeber and Kasper Iversen",
note = "{\textcopyright} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2020",
month = oct,
day = "5",
doi = "10.1136/openhrt-2020-001380",
language = "English",
volume = "7",
journal = "Open Heart",
issn = "2053-3624",
publisher = "BMJ Publishing Group",
number = "2",

}

RIS

TY - JOUR

T1 - Coronary risk of patients with valvular heart disease

T2 - prospective validation of CT-Valve Score

AU - Hasselbalch, Rasmus Bo

AU - Pries-Heje, Mia Marie

AU - Kjølhede Holle, Sarah Louise

AU - Engstrøm, Thomas

AU - Heitmann, Merete

AU - Pedersen, Frants

AU - Schou, Morten

AU - Mickley, Hans

AU - Elming, Hanne

AU - Steffensen, Rolf

AU - Koeber, Lars

AU - Iversen, Kasper

N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2020/10/5

Y1 - 2020/10/5

N2 - OBJECTIVE: To prospectively validate the CT-Valve score, a new risk score designed to identify patients with valvular heart disease at a low risk of coronary artery disease (CAD) who could benefit from multislice CT (MSCT) first instead of coronary angiography (CAG).METHODS: This was a prospective cohort study of patients referred for valve surgery in the Capital Region of Denmark and Odense University Hospital from the 1 February 2015 to the 1 February 2017. MSCT was implemented for patients with a CT-Valve score ≤7 at the referring physician's discretion. Patients with a history of CAD or chronic kidney disease were excluded. The primary outcome was the proportion of patients needing reevaluation with CAG after MSCT and risk of CAD among the patients determined to be low to intermediate risk.RESULTS: In total, 1149 patients were included. The median score was 9 (IQR 3) and 339 (30%) had a score ≤7. MSCT was used for 117 patients. Of these 29 (25%) were reevaluated and 9 (7.7%) had CAD. Of the 222 patients with a score ≤7 that did not receive an MSCT, 14 (6%) had significant CAD. The estimated total cost of evaluation among patients with a score ≤7 before implementation was €132 093 compared with €79 073 after, a 40% reduction. Similarly, estimated total radiation before and after was 608 mSv and 362 mSv, a 41% reduction. Follow-up at a median of 32 months (18-48) showed no ischaemic events for patients receiving only MSCT.CONCLUSION: The CT-Valve score is a valid method for determining risk of CAD among patients with valvular heart disease. Using a score ≤7 as a cut-off for the use of MSCT is safe and cost-effective.

AB - OBJECTIVE: To prospectively validate the CT-Valve score, a new risk score designed to identify patients with valvular heart disease at a low risk of coronary artery disease (CAD) who could benefit from multislice CT (MSCT) first instead of coronary angiography (CAG).METHODS: This was a prospective cohort study of patients referred for valve surgery in the Capital Region of Denmark and Odense University Hospital from the 1 February 2015 to the 1 February 2017. MSCT was implemented for patients with a CT-Valve score ≤7 at the referring physician's discretion. Patients with a history of CAD or chronic kidney disease were excluded. The primary outcome was the proportion of patients needing reevaluation with CAG after MSCT and risk of CAD among the patients determined to be low to intermediate risk.RESULTS: In total, 1149 patients were included. The median score was 9 (IQR 3) and 339 (30%) had a score ≤7. MSCT was used for 117 patients. Of these 29 (25%) were reevaluated and 9 (7.7%) had CAD. Of the 222 patients with a score ≤7 that did not receive an MSCT, 14 (6%) had significant CAD. The estimated total cost of evaluation among patients with a score ≤7 before implementation was €132 093 compared with €79 073 after, a 40% reduction. Similarly, estimated total radiation before and after was 608 mSv and 362 mSv, a 41% reduction. Follow-up at a median of 32 months (18-48) showed no ischaemic events for patients receiving only MSCT.CONCLUSION: The CT-Valve score is a valid method for determining risk of CAD among patients with valvular heart disease. Using a score ≤7 as a cut-off for the use of MSCT is safe and cost-effective.

KW - coronary artery disease

KW - risk stratification

KW - valvular disease

UR - http://www.scopus.com/inward/record.url?scp=85092783685&partnerID=8YFLogxK

U2 - 10.1136/openhrt-2020-001380

DO - 10.1136/openhrt-2020-001380

M3 - Journal article

C2 - 33020259

VL - 7

JO - Open Heart

JF - Open Heart

SN - 2053-3624

IS - 2

M1 - e001380

ER -

ID: 61009662