P1850 - Prospective validation of an acoustic-based system for the detection of obstructive coronary artery disease in a high prevalence population(VALIDATE)

M Renker; S Kriechbaum; Samuel Emil Schmidt; JS Wolter; O Dörr; U Fischer-Rasokat; WK Kim; C Liebetrau; Morten Bøttcher; H Nef; T Bauer; CW Hamm

doi:10.1007/s00392-020-01621-0

P1850 - Prospective validation of an acoustic-based system for the detection of obstructive coronary artery disease in a high prevalence population(VALIDATE)

M Renker, S Kriechbaum, Samuel Emil Schmidt, JS Wolter, O Dörr, U Fischer-Rasokat, WK Kim, C Liebetrau, Morten Bøttcher, H Nef, T Bauer, CW Hamm

Research output: Contribution to journal › Conference abstract in journal › Research › peer-review

Abstract

Background: Recent guidelines recommend a risk-adjusted non-invasive workup in patients presenting with chest discomfort to support or exclude the diagnosis of stable coronary artery disease (CAD). However, a risk-adjusted diagnostic approach remains challenging in clinical practice. An acoustic detection device for analyzing micro-bruits induced by stenosis-generated turbulence in the coronary circulation has now been developed and has shown potential for ruling out CAD in patients with low to intermediate likelihood.Objective: To examine the diagnostic value of an acoustic detection device in a high-prevalence cohort.Methods: Between 1/2016 and 2/2017, a total of 226 patients without prior invasive coronary angiography (ICA) were prospectively enrolled at two centers and were examined using a portable acoustic detection system. In a double-blinded fashion, the acoustic analysis was performed both prior to ICA with quantitative coronary analysis and following percutaneous coronary intervention (PCI).Results: A CAD score was obtained in 213 of 226 patients (94%). The mean CAD score prior to ICA was 41.2±11.9 in patients with obstructive CAD compared with 33.8±13.4in patients without obstructive CAD (p<0.001). ROC analysis revealed an AUC of 0.661 (95% CI 0.584-0.737) for the diagnosis of obstructive CAD. The sensitivity was 97.6% (95% CI 91.5-99.7%), the specificity was 14.5% (95% CI 9.0-21.7%), the negative predictive value was 90.5% (95% CI 69.6-98.8%), and the positive predictive value was 41.7% (95% CI 34.6-49.0%). Following PCI, a significant decrease in the mean CAD score was observed (38.3±13.7 vs. 40.5±11.2; p=0.039).Conclusion: Use of an acoustic detection device allowed the identification of individuals with CAD in a high-prevalence cohort with a high sensitivity of 97.6% but with a lower specificity. The negative predictive value of 90.5% was within the predicted range for a high-prevalence cohort and could potentially allow a rapid rule-out of obstructive CAD even in a high-prevalence population.

Original language	English
Journal	Clinical Research in Cardiology
Volume	109
Number of pages	1
ISSN	1861-0684
DOIs	https://doi.org/10.1007/s00392-020-01621-0
Publication status	Published - 2020
Event	86th Annual Meeting of the German Cardiac Society: Cardiac and Circulation Research - Berlin, Germany Duration: 14 Oct 2020 → 17 Oct 2020

Conference

Conference	86th Annual Meeting of the German Cardiac Society
Country/Territory	Germany
City	Berlin
Period	14/10/2020 → 17/10/2020

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10.1007/s00392-020-01621-0

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Renker, M., Kriechbaum, S., Schmidt, S. E., Wolter, JS., Dörr, O., Fischer-Rasokat, U., Kim, WK., Liebetrau, C., Bøttcher, M., Nef, H., Bauer, T., & Hamm, CW. (2020). P1850 - Prospective validation of an acoustic-based system for the detection of obstructive coronary artery disease in a high prevalence population(VALIDATE). Clinical Research in Cardiology, 109. https://doi.org/10.1007/s00392-020-01621-0

@article{53acfeaf4a35450d94b59e91b21dad26,

title = "P1850 - Prospective validation of an acoustic-based system for the detection of obstructive coronary artery disease in a high prevalence population(VALIDATE)",

abstract = "Background: Recent guidelines recommend a risk-adjusted non-invasive workup in patients presenting with chest discomfort to support or exclude the diagnosis of stable coronary artery disease (CAD). However, a risk-adjusted diagnostic approach remains challenging in clinical practice. An acoustic detection device for analyzing micro-bruits induced by stenosis-generated turbulence in the coronary circulation has now been developed and has shown potential for ruling out CAD in patients with low to intermediate likelihood.Objective: To examine the diagnostic value of an acoustic detection device in a high-prevalence cohort.Methods: Between 1/2016 and 2/2017, a total of 226 patients without prior invasive coronary angiography (ICA) were prospectively enrolled at two centers and were examined using a portable acoustic detection system. In a double-blinded fashion, the acoustic analysis was performed both prior to ICA with quantitative coronary analysis and following percutaneous coronary intervention (PCI).Results: A CAD score was obtained in 213 of 226 patients (94%). The mean CAD score prior to ICA was 41.2±11.9 in patients with obstructive CAD compared with 33.8±13.4in patients without obstructive CAD (p<0.001). ROC analysis revealed an AUC of 0.661 (95% CI 0.584-0.737) for the diagnosis of obstructive CAD. The sensitivity was 97.6% (95% CI 91.5-99.7%), the specificity was 14.5% (95% CI 9.0-21.7%), the negative predictive value was 90.5% (95% CI 69.6-98.8%), and the positive predictive value was 41.7% (95% CI 34.6-49.0%). Following PCI, a significant decrease in the mean CAD score was observed (38.3±13.7 vs. 40.5±11.2; p=0.039).Conclusion: Use of an acoustic detection device allowed the identification of individuals with CAD in a high-prevalence cohort with a high sensitivity of 97.6% but with a lower specificity. The negative predictive value of 90.5% was within the predicted range for a high-prevalence cohort and could potentially allow a rapid rule-out of obstructive CAD even in a high-prevalence population.",

author = "M Renker and S Kriechbaum and Schmidt, {Samuel Emil} and JS Wolter and O D{\"o}rr and U Fischer-Rasokat and WK Kim and C Liebetrau and Morten B{\o}ttcher and H Nef and T Bauer and CW Hamm",

year = "2020",

doi = "10.1007/s00392-020-01621-0",

language = "English",

volume = "109",

journal = "Clinical Research in Cardiology",

issn = "1861-0684",

publisher = "Springer",

note = "86th Annual Meeting of the German Cardiac Society : Cardiac and Circulation Research ; Conference date: 14-10-2020 Through 17-10-2020",

}

Renker, M, Kriechbaum, S, Schmidt, SE, Wolter, JS, Dörr, O, Fischer-Rasokat, U, Kim, WK, Liebetrau, C, Bøttcher, M, Nef, H, Bauer, T & Hamm, CW 2020, 'P1850 - Prospective validation of an acoustic-based system for the detection of obstructive coronary artery disease in a high prevalence population(VALIDATE)', Clinical Research in Cardiology, vol. 109. https://doi.org/10.1007/s00392-020-01621-0

P1850 - Prospective validation of an acoustic-based system for the detection of obstructive coronary artery disease in a high prevalence population(VALIDATE). / Renker, M; Kriechbaum, S; Schmidt, Samuel Emil et al.
In: Clinical Research in Cardiology, Vol. 109, 2020.

Research output: Contribution to journal › Conference abstract in journal › Research › peer-review

TY - ABST

T1 - P1850 - Prospective validation of an acoustic-based system for the detection of obstructive coronary artery disease in a high prevalence population(VALIDATE)

AU - Renker, M

AU - Kriechbaum, S

AU - Schmidt, Samuel Emil

AU - Wolter, JS

AU - Dörr, O

AU - Fischer-Rasokat, U

AU - Kim, WK

AU - Liebetrau, C

AU - Bøttcher, Morten

AU - Nef, H

AU - Bauer, T

AU - Hamm, CW

PY - 2020

Y1 - 2020

N2 - Background: Recent guidelines recommend a risk-adjusted non-invasive workup in patients presenting with chest discomfort to support or exclude the diagnosis of stable coronary artery disease (CAD). However, a risk-adjusted diagnostic approach remains challenging in clinical practice. An acoustic detection device for analyzing micro-bruits induced by stenosis-generated turbulence in the coronary circulation has now been developed and has shown potential for ruling out CAD in patients with low to intermediate likelihood.Objective: To examine the diagnostic value of an acoustic detection device in a high-prevalence cohort.Methods: Between 1/2016 and 2/2017, a total of 226 patients without prior invasive coronary angiography (ICA) were prospectively enrolled at two centers and were examined using a portable acoustic detection system. In a double-blinded fashion, the acoustic analysis was performed both prior to ICA with quantitative coronary analysis and following percutaneous coronary intervention (PCI).Results: A CAD score was obtained in 213 of 226 patients (94%). The mean CAD score prior to ICA was 41.2±11.9 in patients with obstructive CAD compared with 33.8±13.4in patients without obstructive CAD (p<0.001). ROC analysis revealed an AUC of 0.661 (95% CI 0.584-0.737) for the diagnosis of obstructive CAD. The sensitivity was 97.6% (95% CI 91.5-99.7%), the specificity was 14.5% (95% CI 9.0-21.7%), the negative predictive value was 90.5% (95% CI 69.6-98.8%), and the positive predictive value was 41.7% (95% CI 34.6-49.0%). Following PCI, a significant decrease in the mean CAD score was observed (38.3±13.7 vs. 40.5±11.2; p=0.039).Conclusion: Use of an acoustic detection device allowed the identification of individuals with CAD in a high-prevalence cohort with a high sensitivity of 97.6% but with a lower specificity. The negative predictive value of 90.5% was within the predicted range for a high-prevalence cohort and could potentially allow a rapid rule-out of obstructive CAD even in a high-prevalence population.

AB - Background: Recent guidelines recommend a risk-adjusted non-invasive workup in patients presenting with chest discomfort to support or exclude the diagnosis of stable coronary artery disease (CAD). However, a risk-adjusted diagnostic approach remains challenging in clinical practice. An acoustic detection device for analyzing micro-bruits induced by stenosis-generated turbulence in the coronary circulation has now been developed and has shown potential for ruling out CAD in patients with low to intermediate likelihood.Objective: To examine the diagnostic value of an acoustic detection device in a high-prevalence cohort.Methods: Between 1/2016 and 2/2017, a total of 226 patients without prior invasive coronary angiography (ICA) were prospectively enrolled at two centers and were examined using a portable acoustic detection system. In a double-blinded fashion, the acoustic analysis was performed both prior to ICA with quantitative coronary analysis and following percutaneous coronary intervention (PCI).Results: A CAD score was obtained in 213 of 226 patients (94%). The mean CAD score prior to ICA was 41.2±11.9 in patients with obstructive CAD compared with 33.8±13.4in patients without obstructive CAD (p<0.001). ROC analysis revealed an AUC of 0.661 (95% CI 0.584-0.737) for the diagnosis of obstructive CAD. The sensitivity was 97.6% (95% CI 91.5-99.7%), the specificity was 14.5% (95% CI 9.0-21.7%), the negative predictive value was 90.5% (95% CI 69.6-98.8%), and the positive predictive value was 41.7% (95% CI 34.6-49.0%). Following PCI, a significant decrease in the mean CAD score was observed (38.3±13.7 vs. 40.5±11.2; p=0.039).Conclusion: Use of an acoustic detection device allowed the identification of individuals with CAD in a high-prevalence cohort with a high sensitivity of 97.6% but with a lower specificity. The negative predictive value of 90.5% was within the predicted range for a high-prevalence cohort and could potentially allow a rapid rule-out of obstructive CAD even in a high-prevalence population.

UR - https://www.abstractserver.com/dgk2020/jt/abstracts/P1850.htm

U2 - 10.1007/s00392-020-01621-0

DO - 10.1007/s00392-020-01621-0

M3 - Conference abstract in journal

SN - 1861-0684

VL - 109

JO - Clinical Research in Cardiology

JF - Clinical Research in Cardiology

T2 - 86th Annual Meeting of the German Cardiac Society

Y2 - 14 October 2020 through 17 October 2020

ER -

P1850 - Prospective validation of an acoustic-based system for the detection of obstructive coronary artery disease in a high prevalence population(VALIDATE)

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