Logistic regression analysis of multiple noninvasive tests for the prediction of the presence and extent of coronary artery disease in men

Journal Article · Thu Aug 01 04:00:00 EDT 1985 · Am. Heart J.; (United States)

DOI:https://doi.org/10.1016/0002-8703(85)90170-X· OSTI ID:5126802

Hung, J; Chaitman, B R; Lam, J; Lesperance, J; Dupras, G; Fines, P; Cherkaoui, O; Robert, P; Bourassa, M G

The incremental diagnostic yield of clinical data, exercise ECG, stress thallium scintigraphy, and cardiac fluoroscopy to predict coronary and multivessel disease was assessed in 171 symptomatic men by means of multiple logistic regression analyses. When clinical variables alone were analyzed, chest pain type and age were predictive of coronary disease, whereas chest pain type, age, a family history of premature coronary disease before age 55 years, and abnormal ST-T wave changes on the rest ECG were predictive of multivessel disease. The percentage of patients correctly classified by cardiac fluoroscopy (presence or absence of coronary artery calcification), exercise ECG, and thallium scintigraphy was 9%, 25%, and 50%, respectively, greater than for clinical variables, when the presence or absence of coronary disease was the outcome, and 13%, 25%, and 29%, respectively, when multivessel disease was studied; 5% of patients were misclassified. When the 37 clinical and noninvasive test variables were analyzed jointly, the most significant variable predictive of coronary disease was an abnormal thallium scan and for multivessel disease, the amount of exercise performed. The data from this study provide a quantitative model and confirm previous reports that optimal diagnostic efficacy is obtained when noninvasive tests are ordered sequentially. In symptomatic men, cardiac fluoroscopy is a relatively ineffective test when compared to exercise ECG and thallium scintigraphy.

• Research Organization: Montreal Heart Institute, Quebec, Canada
• OSTI ID: 5126802
• Journal Information: Am. Heart J.; (United States), Journal Name: Am. Heart J.; (United States) Vol. 2; ISSN AHJOA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
BODY
BODY AREAS
CARDIOVASCULAR DISEASES
CHEST
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGRAMS
DISEASES
ELECTROCARDIOGRAMS
EXERCISE
FLUOROSCOPY
ISOTOPES
MATHEMATICAL MODELS
MATHEMATICS
MEDICINE
NUCLEAR MEDICINE
PAIN
PATIENTS
RADIOISOTOPE SCANNING
RADIOLOGY
REGRESSION ANALYSIS
SCINTISCANNING
STATISTICS
SYMPTOMS
THALLIUM ISOTOPES