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External validation of the CRAX2MACE model.

Waseem Hijazi¹, Willam Leslie², Neil Filipchuk¹

¹Department of Cardiac Sciences, University of Calgary, GAA08, 3230 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology

|April 14, 2022

Summary

This summary is machine-generated.

The CRAX2MACE score accurately predicts 2-year major adverse cardiovascular events (MACE) risk in patients with suspected coronary artery disease (CAD). This score outperforms quantitative perfusion measures in external validation studies.

Keywords:

MPI Risk stratification SPECT myocardial perfusion imaging

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Area of Science:

Cardiology
Nuclear Medicine
Medical Imaging

Background:

Single-photon emission computed tomography (SPECT) myocardial perfusion imaging is a standard tool for assessing cardiovascular risk.
Accurate prediction of major adverse cardiovascular events (MACE) is crucial for guiding patient management in suspected coronary artery disease (CAD).

Purpose of the Study:

To externally validate the predictive performance of the CRAX2MACE score for 2-year MACE.
To compare the CRAX2MACE score's accuracy against quantitative perfusion metrics derived from SPECT.

Main Methods:

A cohort of 2,985 patients undergoing clinically indicated SPECT with MACE follow-up was analyzed.
The CRAX2MACE score's prediction for 2-year MACE was evaluated using area under the receiver operating characteristic curve (AUC).
Calibration was assessed using calibration plots, Brier score, and the Hosmer-Lemeshow test.

Main Results:

The CRAX2MACE score demonstrated a significantly higher AUC (0.710) for predicting 2-year MACE compared to stress TPD (0.669) and ischemic TPD (0.664).
The model showed acceptable goodness-of-fit (P = .103) and good calibration (Brier score = 0.071).

Conclusions:

The CRAX2MACE score offers superior predictive performance for 2-year MACE compared to quantitative perfusion measures in an independent patient cohort.
The CRAX2MACE score is a simple tool that can aid physicians in cardiovascular risk stratification.