Cardiac arrest & resuscitation
Visual coronary artery calcification score to predict significant coronary artery stenosis in patients presenting with cardiac arrest without ST-segment elevation myocardial infarction
Authors' conclusion
The present study found that a non-dedicated CT thorax may be useful to measure VCAC and if this is scored ≥ 4 it allows physicians to better select patients resuscitated from cardiac arrest with non-STEMI and without history of coronary artery disease who may benefit from an emergency coronary angiogram to detect a significant or culprit coronary artery stenosis and had PCI if appropriate.
Study context
- Population
- Patients with cardiac arrest without STEMI who had coronary angiogram and chest CT, Croix-Rousse Hospital, Lyon, France, January 2013 to March 2023
- Participants
- 113 patients
- Comparison
- Visual coronary artery calcification (VCAC) score on chest CT to predict significant coronary stenosis, culprit lesion or percutaneous coronary intervention (PCI)
- Outcome
- Significant coronary artery stenosis on coronary angiogram
Methodological detailssingle-centre
- Single-centre
Performance
As reported in the abstract
| Test or model | AUC | Optimal threshold | Specificity | Sensitivity |
|---|---|---|---|---|
| VCAC score | 0.95 (95%CI [0.90-1.00]) | ≥ 4 | 94.7% | 91.9% |
VCAC score
Further findings
Culprit coronary artery stenosis (optimal threshold ≥ 5)
- AUC
- 0.90 (95%CI [0.85-0.96])
- Specificity
- 83.5%
- Sensitivity
- 87.5%
Ad hoc PCI (optimal threshold VCAC ≥ 5)
- AUC [0.823-0.948]
- 0.886
- Specificity
- 81.8%
- Sensitivity
- 85.7%
Delayed and ad hoc PCI (optimal threshold VCAC ≥ 5)
- AUC [0.872-0.972]
- 0.921
- Specificity
- 85.3%
- Sensitivity
- 88.9%
Significant or culprit stenosis and ad hoc or delayed PCI (VCAC score ≥ 4)
- Sensitivity
- 100%
Original publication
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