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Coronary angiographic scoring systems: an evaluation of their equivalence and validity

Ian J Neeland1, Riyaz S Patel, Parham Eshtehardi

  • 1Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

American Heart Journal
|October 17, 2012
PubMed

Insights

Coronary artery disease scoring systems correlate well with each other and with plaque burden. Angiographic scores provide a valid estimate of coronary artery disease severity.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Multiple scoring systems exist to quantify coronary artery disease (CAD) burden from angiography.
  • The relationship between these scores and their accuracy in reflecting actual plaque burden is not well understood.

Purpose of the Study:

  • To compare commonly used angiographic scoring systems against each other.
  • To assess the correlation of these angiographic scores with intravascular ultrasound (IVUS)-derived plaque burden.

Main Methods:

  • Scored coronary angiographic data from 3600 patients using 10 different systems.
  • Quantified plaque burden and area in a subset of 50 patients using IVUS in the left anterior descending artery.

Main Results:

  • All 10 angiographic scoring systems showed strong intercorrelations (Spearman's ρ, 0.79-0.98).
  • All systems correlated significantly with IVUS-measured plaque burden (ρ, 0.56-0.78) and plaque area (ρ, 0.43-0.62).
  • The CASS-50 score demonstrated the strongest correlation with plaque burden and area.

Conclusions:

  • Angiographic scoring systems are highly correlated with each other.
  • These scoring systems serve as a valid estimation of atherosclerotic plaque burden in coronary artery disease.
Abstract

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