valor preditivo da angina em detectar doença coronariana em pacientes com estenose aórtica grave a partir da quinta década de vida predictive value of angina to detect coronary artery disease in patients with severe aortic stenosis aged 50 years or older

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ID: 191947
2006
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Abstract
OBJETIVO: O objetivo deste estudo é verificar o valor de previsão da angina de peito no diagnóstico da DAC em pacientes portadores de EA, a partir da quinta década de vida. MÉTODOS: A população estudada foi constituída por 186 pacientes consecutivos com EA e idade e" 50 anos, referidos para cirurgia de troca valvar aórtica entre junho de 1989 e setembro de 2004. Cinecoronariografia de rotina foi realizada em todos os pacientes. Cento e um eram homens (54,3%) e 85, mulheres (45,7%), com idade de 66±8 anos. Angina estava presente em 124 pacientes (66,7%). O gradiente máximo transvalvar aórtico foi de 89,4±27,6 mmHg e a área valvar aórtica de 0,59±0,17 cm2. Calculamos a sensibilidade, a especificidade, o valor de previsão positivo e negativo e a razão de verossimilhança positiva da angina na predição da presença de DAC. RESULTADOS: DAC estava presente em 93 pacientes (50%). Dos 124 pacientes com angina, 68 (54,8%) apresentavam DAC; enquanto dos 62 sem angina, 25 apresentavam DAC (40,3%). Portanto, a sensibilidade da angina para DAC foi de 73,1%, a especificidade de 39,7%, valor preditivo positivo de 54,8%, valor preditivo negativo de 59,6% e razão de verossimilhança positiva de 1,6. CONCLUSÃO: A angina de peito não é bom preditor da presença de DAC em pacientes com EA a partir da quinta década de vida.
OBJECTIVE: The objective of this study is to evaluate the value of angina pectoris as a predictor of CAD (coronary artery disease) in patients with AS (aortic stenosis) during and beyond the 5th decade of life. METHODS: The study population consisted of 186 consecutive patients with AS and e" 50 years of age, referred for surgical aortic valve replacement (AVR) between June 1989 and September 2004. Routine coronary angiography was performed for all patients. One hundred and one patients were males (54.3%) and 85 were females (45.7%), and the mean age was 66±8 years. One hundred and twenty-four patients (66.7%) had angina. The maximum transvalve gradient was 89.4±27.6 mmHg, and the aortic valve area measured 0.59±0.17 cm2. We calculated the sensitivity, specificity, positive and negative predictive values, as well as the likelihood ratio of a positive test result for angina in predicting the presence of CAD. RESULTS: Ninety-three patients (50%) had CAD. Of the 124 patients with angina, 68 (54.8%) had CAD, whereas of the 62 patients without angina, 25 had CAD (40.3%) (p=0.087). Therefore, the diagnostic sensitivity of angina to detect CAD was 73.1%, specificity was 39.7%, positive predictive value was 54.8%, negative predictive value was 59.6%, and the likelihood ratio of a positive test result was 1.6. CONCLUSION: Angina pectoris is not a good predictor of CAD in patients with AS who are more than 50 years of age.
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Authors Aline Alves Vargas Gonçalves, Fabíola Lúcio Cardão, Maria Gabriela Gomes Soares, André Weksler, Clara Weksler, Bernardo Rangel Tura, Paulo Roberto Dutra da Silva, Antônio Sérgio Cordeiro da Rocha
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Journal revista cubana de ciencias informáticas
Year 2006
DOI
10.1590/S0066-782X2006001900004
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2006001900004
Keywords
aortic valve stenosis

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