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Authors
Advisor(s)
Abstract(s)
A Doença da Artéria Coronária (DAC) a principal causa de morbilidade e mortalidade em países desenvolvidos e em desenvolvimento. Além da angiografia coronária invasiva, sendo considerado o Gold standard para avaliar a gravidade da estenose anatómica, a realização de testes não invasivos tem sido defendida recentemente para fornecer uma avaliação anatómica e/ou funcional da artéria coronária. Entre esses métodos de diagnóstico, a Prova de Esforço é um procedimento corrente e de baixo custo para avaliar pacientes de risco intermédio com angina de peito. A realização deste projeto tem por objetivo geral verificar a acuidade da Prova de esforço para detetar doença isquémica do miocárdio. A amostra foi constituída por todos os doentes que realizaram Prova de Esforço no período de 6 meses, no Hospital de Santa Luzia de Elvas, com autorização do Conselho de Administração e Comissão de Ética do mesmo, recorrendo à base de dados SClínico. A dimensão da amostra é constituída por 184 doentes dos quais apenas 18 (9,8%) foram encaminhados para Cateterismo Cardíaco/CPM. A partir da metodologia Receiver Operating Curves (ROC) avaliou-se o desempenho da Prova de Esforço no diagnóstico de Isquemia do Miocárdio. No estudo realizado, verificou-se que a Prova de Esforço apresenta um elevado grau de exatidão (AUC=0,96), uma vez que os eventos ocorridos após a mesma foram de 10%. No entanto, a comparação com a Cintigrafia de Perfusão do Miocárdio (CPM) ou o Cateterismo Cardíaco foi quase impossível devido ao baixo número de doentes com Prova de Esforço Positiva.
ABSTRACT - Coronary Artery Disease (CAD) is one of the leading causes of morbidity and mortality in developed and developing countries. In addition to invasive coronary, which is the gold standard for assessing the severity of anatomic stenosis, a variety of this noninvasive test has recently been advocated to provide an anatomical and/or functional assessment of the coronary artery. Among these diagnostic methods, the Stress Test is a current and cost-effective procedure to evaluate intermediate-risk patients with angina pectoris. The accomplishment of this project has the general objective to verify the accuracy of the Stress Test to detect ischemic myocardial disease. The sample consisted of all patients who underwent Stress Test in the 6-month period, at the Santa Luzia Hospital of Elvas, with authorization from the Board of Directors and Ethics Committee of the same, using the clinical database. The sample size consists of 184 patients of whom only 18 (9.8%) were referred for Cardiac Catheterization / MPS. From the Receiver Operating Curves methodology (ROC Curve) the performance of the Stress Test was evaluated in the diagnosis of Myocardial Ischemia. In the present study, it was verified that in fact, the Stress Test shows a high degree of accuracy (AUC = 0.96) since the events occurred after the same was 10%. However, the comparison with Myocardial Perfusion Scintigraphy (MPS) or Cardiac Catheterization was almost impossible due to the low number of patients with the Positive Stress Test.
ABSTRACT - Coronary Artery Disease (CAD) is one of the leading causes of morbidity and mortality in developed and developing countries. In addition to invasive coronary, which is the gold standard for assessing the severity of anatomic stenosis, a variety of this noninvasive test has recently been advocated to provide an anatomical and/or functional assessment of the coronary artery. Among these diagnostic methods, the Stress Test is a current and cost-effective procedure to evaluate intermediate-risk patients with angina pectoris. The accomplishment of this project has the general objective to verify the accuracy of the Stress Test to detect ischemic myocardial disease. The sample consisted of all patients who underwent Stress Test in the 6-month period, at the Santa Luzia Hospital of Elvas, with authorization from the Board of Directors and Ethics Committee of the same, using the clinical database. The sample size consists of 184 patients of whom only 18 (9.8%) were referred for Cardiac Catheterization / MPS. From the Receiver Operating Curves methodology (ROC Curve) the performance of the Stress Test was evaluated in the diagnosis of Myocardial Ischemia. In the present study, it was verified that in fact, the Stress Test shows a high degree of accuracy (AUC = 0.96) since the events occurred after the same was 10%. However, the comparison with Myocardial Perfusion Scintigraphy (MPS) or Cardiac Catheterization was almost impossible due to the low number of patients with the Positive Stress Test.
Description
Mestrado em Gestão e Avaliação de Tecnologias em Saúde
Keywords
Prova de esforço Isquémia do miocárdio Cateterismo cardíaco Cintigrafia de perfusão ROC Stress test Myocardial ischemia Cardiac catheterization Perfusion scintigraphy Receiver operating curves
Citation
Henriques CS. Avaliação da capacidade de exames complementares de diagnóstico para a deteção de doença isquémica do miocárdio [dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; Escola Superior de Saúde da Universidade do Algarve; 2019.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa