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Background Traditionally the gold standard for diagnosis of coronary artery disease (CAD) is detection of significant stenosis by coronary angiography. However, most myocardial infarctions result from ruptures of plaques that did not significantly compromise coronary lumen before the event. It was proved that significant stenosis is associated with stable CAD but non-significant coronary atherosclerosis is associated with unstable angina and acute coronary syndrome. Purpose To reveal predictors of non-significant coronary atherosclerosis using echocardiographic and clinical parameters in suspected CAD men without obstructive CAD by coronary angiography. Methods Out of 17.784 patients from coronary angiography database we selected 1.957 men without obstructive CAD. Selected men were divided into two groups randomly (1.389 - studied group and 568 – test group). The studied group was divided into subgroups: 304 men with non-significant coronary atherosclerosis (luminal narrowing or stenosis less than 30%) and 1.085 men with smooth coronary artery. Clinical and functional parameters of subgroups patients were compared. For selection of scoring variables, we used the values of the Cramer coefficient and the information value index - IV. All quantitative variables were converted into categorical using the binning procedure. Based on the values of WoE, the model of logistic regression was constructed using stepwise variable selection. Results The model includes independent variables with an average and high prognostic ability: echocardiographic signs of atherosclerosis of the ascending aorta, age, atherogenic index, arterial hypertension. By converting the coefficients of the logistic regression equation obtained into scores, a scoring model was developed to assess the probability of non-obstructive coronary atherosclerosis in men. Based on ROC analysis, in the studied group the specificity of the model for detection of nonsignificant coronary atherosclerosis was 67%, the sensitivity was 65%, the area under the ROC curve - 0.711. For the patients of the test group sensitivity was 68% and specificity - 63%, the area under the ROC curve - 0.687. Conclusion Nonsignificant coronary atherosclerosis in men with suspected CAD can be predicted before CAG by screening test based on echocardiographic signs of aortic atherosclerosis, age, atherogenic index and arterial hypertension.

european heart journal. cardiovascular imaging

1179 Echocardiographic signs of aortic atherosclerosis in combination with clinical parameters for prediction of non-obstructive coronary atherosclerosis in men