Cardiogoniometric parameters for detection of coronary artery disease at rest as a function of stenosis localization and distribution

Cardiogoniometry (CGM), a spatiotemporal electrocardiologic 5-lead method with automated analysis, may be useful in primary healthcare for detecting coronary artery disease (CAD) at rest. Our aim was to systematically develop a stenosis-specific parameter set for global CAD detection. In 793 consecutively admitted patients with presumed non-acute CAD, CGM data were collected prior to elective coronary angiography and analyzed retrospectively. 658 patients fulfilled the inclusion criteria, 405 had CAD verified by coronary angiography; the 253 patients with normal coronary angiograms served as the non-CAD controls. Study patients--matched for age, BMI, and gender--were angiographically assigned to 8 stenosis-specific CAD categories or to the controls. One CGM parameter possessing significance (P < .05) and the best diagnostic accuracy was matched to one CAD category. The area under the ROC curve was .80 (global CAD versus controls). A set containing 8 stenosis-specific CGM parameters described variability of R vectors and R-T angles, spatial position and potential distribution of R/T vectors, and ST/T segment alterations. Our parameter set systematically combines CAD categories into an algorithm that detects CAD globally. Prospective validation in clinical studies is ongoing

Tornado diagram of one-way sensitivity analysis for DBS versus BMT (plausible parameter ranges).

<p>Tornado diagram of one-way sensitivity analysis for DBS versus BMT (plausible parameter ranges).</p

Cumulative discounted QALYs over 15 years.

<p>Cumulative discounted QALYs over 15 years.</p

Cumulative discounted costs over 15 years.

<p>Cumulative discounted costs over 15 years.</p

Deterministic model results (discounted).

<p>Deterministic model results (discounted).</p

Model diagram BMT = best medical therapy; DBS = Deep brain stimulation.

<p>Model diagram BMT = best medical therapy; DBS = Deep brain stimulation.</p

Cost-effectiveness acceptability curve.

<p>Cost-effectiveness acceptability curve.</p

Cost breakdown by treatment.

<p>Cost breakdown by treatment.</p