Calculate 2025 COME-CCT-PTP with CTA for obstructive CAD

This function returns a patient's pre-test probability (PTP) of obstructive coronary artery disease (CAD) based on the 2025 Collaborative Meta-Analysis of Cardiac CT (COME-CCT) with CTA PTP model. Obstructive coronary artery disease was defined as at least one \(\geq\) 50% diameter stenosis by invasive coronary angiography (ICA).

Usage

calculate_come_cct_with_cta_2025_ptp(
  age,
  sex,
  chest_pain_type,
  cta_result,
  label_sex_male = c("male"),
  label_sex_female = c("female"),
  label_sex_unknown = c(NA, NaN),
  label_cpt_nonanginal = c("nonanginal"),
  label_cpt_atypical = c("atypical"),
  label_cpt_typical = c("typical"),
  label_cpt_others = c("others"),
  label_cpt_unknown = c(NA, NaN),
  label_cta_obstructive = c("obstructive"),
  label_cta_non_obstructive = c("non_obstructive"),
  label_cta_unknown = c(NA, NaN)
)

Arguments

age

Input numeric value to indicate the age of the patient in years.

sex

The value of variable in the parameters label_sex_male,
label_sex_female and label_sex_unknown.

chest_pain_type

The value of variable in the parameters,
label_cpt_nonanginal, label_cpt_atypical,
label_cpt_typical, label_cpt_others,
and label_cpt_unknown.

cta_result

The value of variable in the parameters,
label_cta_obstructive, label_cta_non_obstructive,
and label_cta_unknown.

label_sex_male

Label(s) for definition(s) of male sex. Default: c("male")

label_sex_female

Label(s) for definition(s) of female sex. Default: c("female")

label_sex_unknown

Label(s) for definition(s) of missing sex. Default: c(NA, NaN)

label_cpt_nonanginal

Label(s) for patient having nonanginal or non-specific chest pain.
Default: c("nonanginal")

label_cpt_atypical

Label(s) for patient having atypical chest pain. Default: c("atypical")

label_cpt_typical

Label(s) for patient having typical chest pain. Default: c("typical")

label_cpt_others

Label(s) for patient having other forms of chest pain. Default: c("others")

label_cpt_unknown

Label(s) for patient having unknown chest pain type symptoms. Default: c(NA, NaN)

label_cta_obstructive

Label(s) for patient having obstructive CAD defined as at least one \(\geq\) 50% diameter stenosis in computed tomography angiography (CTA).
Default: c("obstructive")

label_cta_non_obstructive

Label(s) for patient having non-obstructive CAD defined as at least one < 50% diameter stenosis in computed tomography angiography (CTA).
Default: c("non_obstructive")

label_cta_unknown

Label(s) for patient unknown CTA results. Default: c(NA, NaN)

Value

A numeric value representing the patient's PTP for obstructive CAD based on the 2025 Collaborative Meta-Analysis of Cardiac CT (COME-CCT) with CTA PTP model as shown in Table 2.

Details

The predictive model is based on 5332 stable chest pain patients with clinically indicated ICA from 22 countries.

Model formula used is from Table 3 to obtain results as shown in Table 2.

It is of the form $$\int_{-\infty}^{\infty} \frac{1}{(1 + e^{-(F(x) + \zeta)})} * \frac{1}{\sqrt{2\pi * 0.377}} e^{\frac{-\zeta^2}{2 * 0.377}} \,d\zeta$$ where \(F(x)\) equals $$ \begin{array}{l} -3.030\quad+ \\\\ (0.030 * (age - 61.3))\quad+ \\\\ (0.868 * sex\_is\_male)\quad+ \\\\ (1.346 * have\_typical\_chest\_pain)\quad+ \\\\ (0.195 * have\_atypical\_chest\_pain)\quad+ \\\\ (0.156 * have\_nonanginal\_chest\_pain)\quad+ \\\\ (2.924 * have\_obstructive\_CAD\_in\_CTA) \end{array} $$

Examples

# 40 year old female with typical chest pain
# and obstructive CAD in CTA
calculate_come_cct_with_cta_2025_ptp(
    age = 40,
    sex = "female",
    chest_pain_type = "typical",
    cta_result = "obstructive"
)
#> [1] 0.6350123