Utvärdering av en ny metod för utredning av stabil kranskärlssjukdom baserad på akustisk fonokardiografi

Abstract

Coronary artery disease (CAD) is one of the most common cardiovascular diseases and one of the dominant causes of death in older people worldwide. In order to confirm diagnosis and assess the severity of the disease, several diagnostic strategies are being used today. Increased health costs and long queues for investigations raise concerns among patients, medical doctors and authorities. A simple, safe and cost-effective method that can assist in the investigation of CAD is of major importance. The Danish company Acarix developed a new device, CADScor® system, which uses a non-invasive and radiation-free method to exclude stable CAD based on acoustic phonocardiography. The device records intracoronary murmurs, resulting from coronary stenosis, and calculates the patient's risk of CAD. The purpose of this study was to evaluate the method, test CADScor® and calculate the device's sensitivity, specificity and positive and negative predictive value (PPV and NPV). Twenty patients with suspected stable CAD were examined with CADScor® systems, and their CAD results were compared to the result after myocardial perfusion scan. Calculations showed that the device's sensitivity is 80 %, specificity 60 %, PPV 40 % and NPV 90 %. The result means that the probability is 90 % that a patient who has a CAD score ≤ 20 is healthy. It is high enough to use CADScor® in clinical practice for patients with low risk for CAD.