TY - JOUR
T1 - Advanced heart sound analysis as a new prognostic marker in stable coronary artery disease
AU - Winther, Simon
AU - Nissen, Louise
AU - Schmidt, Samuel Emil
AU - Westra, Jelmer
AU - Andersen, Ina Trolle
AU - Nyegaard, Mette
AU - Madsen, Lene Helleskov
AU - Knudsen, Lars Lyhne
AU - Urbonaviciene, Grazina
AU - Larsen, Bjarke Skogstad
AU - Struijk, Johannes Jan
AU - Frost, Lars
AU - Holm, Niels Ramsing
AU - Christiansen, Evald Høj
AU - Bøtker, Hans Erik
AU - Bøttcher, Morten
N1 - ztab031
PY - 2021/6
Y1 - 2021/6
N2 - Recent technological advances enable diagnosing of obstructive coronary artery disease (CAD) from heart sound analysis with a high negative predictive value. However, the prognostic impact of this approach remains unknown.To investigate the prognostic value of heart sound analysis as two scores, the Acoustic-score and the CAD-score, in patients with suspected CAD which is treated according to standard of care.Consecutive patients with angina symptoms referred for coronary computed tomography angiography (CTA) were enrolled. The Acoustic-score was developed from eight acoustic CAD-related features. This score was combined with risk factors to generate the CAD-score. A cut-off score \gt;20 was pre-specified for both scores to indicate disease. If coronary CTA raised suspicion of obstructive CAD, patients were referred to invasive angiography and revascularized when indicated.Of 1,675 enrolled patients, 1,464 (87.4\ were included in this substudy. The combined primary endpoint was all-cause mortality and myocardial infarction (n = 26). Follow-up was 3.1 [2.7-3.4] years.Of patients with primary endpoints, the Acoustic-score was \gt;20 in 25 (96\; the CAD-score was \gt;20 in 22 (85\. In an unadjusted Cox analysis of the primary endpoints, the hazard ratio for scores \gt;20 under current standard clinical care was 12.6 (1.7-93.2) for the Acoustic-score and 5.4 (1.9-15.7) for the CAD-score. The CAD-score contained prognostic information even after adjusting for lipid-lowering therapy initiation, stenosis at CTA, and early revascularization.Heart sound analysis seems to carries prognostic information and may improve initial risk stratification of patients with suspected CAD.
AB - Recent technological advances enable diagnosing of obstructive coronary artery disease (CAD) from heart sound analysis with a high negative predictive value. However, the prognostic impact of this approach remains unknown.To investigate the prognostic value of heart sound analysis as two scores, the Acoustic-score and the CAD-score, in patients with suspected CAD which is treated according to standard of care.Consecutive patients with angina symptoms referred for coronary computed tomography angiography (CTA) were enrolled. The Acoustic-score was developed from eight acoustic CAD-related features. This score was combined with risk factors to generate the CAD-score. A cut-off score \gt;20 was pre-specified for both scores to indicate disease. If coronary CTA raised suspicion of obstructive CAD, patients were referred to invasive angiography and revascularized when indicated.Of 1,675 enrolled patients, 1,464 (87.4\ were included in this substudy. The combined primary endpoint was all-cause mortality and myocardial infarction (n = 26). Follow-up was 3.1 [2.7-3.4] years.Of patients with primary endpoints, the Acoustic-score was \gt;20 in 25 (96\; the CAD-score was \gt;20 in 22 (85\. In an unadjusted Cox analysis of the primary endpoints, the hazard ratio for scores \gt;20 under current standard clinical care was 12.6 (1.7-93.2) for the Acoustic-score and 5.4 (1.9-15.7) for the CAD-score. The CAD-score contained prognostic information even after adjusting for lipid-lowering therapy initiation, stenosis at CTA, and early revascularization.Heart sound analysis seems to carries prognostic information and may improve initial risk stratification of patients with suspected CAD.
U2 - 10.1093/ehjdh/ztab031
DO - 10.1093/ehjdh/ztab031
M3 - Journal article
SN - 2634-3916
VL - 2
SP - 279
EP - 289
JO - European Heart Journal - Digital Health
JF - European Heart Journal - Digital Health
IS - 2
ER -