Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Self-Report Tool for Identification of Individuals With Coronary Atherosclerosis : The Swedish CardioPulmonary BioImage Study

Bergström, Göran ; Hagberg, Eva ; Björnson, Elias ; Adiels, Martin ; Bonander, Carl ; Strömberg, Ulf ; Andersson, Jonas ; Brunström, Mattias ; Carlhäll, Carl-Johan and Engström, Gunnar LU , et al. (2024) In Journal of the American Heart Association 13(14).
Abstract

BACKGROUND: Coronary atherosclerosis detected by imaging is a marker of elevated cardiovascular risk. However, imaging involves large resources and exposure to radiation. The aim was, therefore, to test whether nonimaging data, specifically data that can be self-reported, could be used to identify individuals with moderate to severe coronary atherosclerosis.

METHODS AND RESULTS: We used data from the population-based SCAPIS (Swedish CardioPulmonary BioImage Study) in individuals with coronary computed tomography angiography (n=25 182) and coronary artery calcification score (n=28 701), aged 50 to 64 years without previous ischemic heart disease. We developed a risk prediction tool using variables that could be assessed from home... (More)

BACKGROUND: Coronary atherosclerosis detected by imaging is a marker of elevated cardiovascular risk. However, imaging involves large resources and exposure to radiation. The aim was, therefore, to test whether nonimaging data, specifically data that can be self-reported, could be used to identify individuals with moderate to severe coronary atherosclerosis.

METHODS AND RESULTS: We used data from the population-based SCAPIS (Swedish CardioPulmonary BioImage Study) in individuals with coronary computed tomography angiography (n=25 182) and coronary artery calcification score (n=28 701), aged 50 to 64 years without previous ischemic heart disease. We developed a risk prediction tool using variables that could be assessed from home (self-report tool). For comparison, we also developed a tool using variables from laboratory tests, physical examinations, and self-report (clinical tool) and evaluated both models using receiver operating characteristic curve analysis, external validation, and benchmarked against factors in the pooled cohort equation. The self-report tool (n=14 variables) and the clinical tool (n=23 variables) showed high-to-excellent discriminative ability to identify a segment involvement score ≥4 (area under the curve 0.79 and 0.80, respectively) and significantly better than the pooled cohort equation (area under the curve 0.76,
P<0.001). The tools showed a larger net benefit in clinical decision-making at relevant threshold probabilities. The self-report tool identified 65% of all individuals with a segment involvement score ≥4 in the top 30% of the highest-risk individuals. Tools developed for coronary artery calcification score ≥100 performed similarly.

CONCLUSIONS: We have developed a self-report tool that effectively identifies individuals with moderate to severe coronary atherosclerosis. The self-report tool may serve as prescreening tool toward a cost-effective computed tomography-based screening program for high-risk individuals.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of the American Heart Association
volume
13
issue
14
publisher
Wiley-Blackwell
external identifiers
  • pmid:38958022
  • scopus:85199125824
ISSN
2047-9980
DOI
10.1161/JAHA.124.034603
language
English
LU publication?
yes
id
05c0278e-81fb-4945-bc20-5d5ca4c77495
date added to LUP
2024-07-08 07:13:59
date last changed
2024-12-24 19:57:17
@article{05c0278e-81fb-4945-bc20-5d5ca4c77495,
  abstract     = {{<p>BACKGROUND: Coronary atherosclerosis detected by imaging is a marker of elevated cardiovascular risk. However, imaging involves large resources and exposure to radiation. The aim was, therefore, to test whether nonimaging data, specifically data that can be self-reported, could be used to identify individuals with moderate to severe coronary atherosclerosis.</p><p>METHODS AND RESULTS: We used data from the population-based SCAPIS (Swedish CardioPulmonary BioImage Study) in individuals with coronary computed tomography angiography (n=25 182) and coronary artery calcification score (n=28 701), aged 50 to 64 years without previous ischemic heart disease. We developed a risk prediction tool using variables that could be assessed from home (self-report tool). For comparison, we also developed a tool using variables from laboratory tests, physical examinations, and self-report (clinical tool) and evaluated both models using receiver operating characteristic curve analysis, external validation, and benchmarked against factors in the pooled cohort equation. The self-report tool (n=14 variables) and the clinical tool (n=23 variables) showed high-to-excellent discriminative ability to identify a segment involvement score ≥4 (area under the curve 0.79 and 0.80, respectively) and significantly better than the pooled cohort equation (area under the curve 0.76,<br>
 P&lt;0.001). The tools showed a larger net benefit in clinical decision-making at relevant threshold probabilities. The self-report tool identified 65% of all individuals with a segment involvement score ≥4 in the top 30% of the highest-risk individuals. Tools developed for coronary artery calcification score ≥100 performed similarly.<br>
 </p><p>CONCLUSIONS: We have developed a self-report tool that effectively identifies individuals with moderate to severe coronary atherosclerosis. The self-report tool may serve as prescreening tool toward a cost-effective computed tomography-based screening program for high-risk individuals.</p>}},
  author       = {{Bergström, Göran and Hagberg, Eva and Björnson, Elias and Adiels, Martin and Bonander, Carl and Strömberg, Ulf and Andersson, Jonas and Brunström, Mattias and Carlhäll, Carl-Johan and Engström, Gunnar and Erlinge, David and Goncalves, Isabel and Gummesson, Anders and Hagström, Emil and Hjelmgren, Ola and James, Stefan and Janzon, Magnus and Jonasson, Lena and Lind, Lars and Magnusson, Martin and Oskarsson, Viktor and Sundström, Johan and Svensson, Per and Söderberg, Stefan and Themudo, Raquel and Östgren, Carl Johan and Jernberg, Tomas}},
  issn         = {{2047-9980}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{14}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of the American Heart Association}},
  title        = {{Self-Report Tool for Identification of Individuals With Coronary Atherosclerosis : The Swedish CardioPulmonary BioImage Study}},
  url          = {{http://dx.doi.org/10.1161/JAHA.124.034603}},
  doi          = {{10.1161/JAHA.124.034603}},
  volume       = {{13}},
  year         = {{2024}},
}