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All Journal Abdimas Talenta : Jurnal Pengabdian Kepada Masyarakat Indonesian Journal of Cardiology Sumatera Medical Journal SCRIPTA SCORE Scientific Medical Journal Heart Science Journal Cardiovascular and Cardiometabolic Journal (CCJ) Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) The Journal of Society Medicine (JSOCMED)
Andra, Cut Aryfa
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Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Risk Factor–Weighted Clinical Probability for Predicting Obstructive Coronary Artery Disease in Patients Presenting with Unstable Angina Batubara , Gio Justisia; Hasan , Refli; Nasution , Ali Nafiah; Hasan, Harris; Lubis, Anggia Chairuddin; Andra, Cut Aryfa
Journal of Society Medicine Vol. 5 No. 3 (2026): March
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i3.271

Abstract

Introduction: Determining the optimal invasive strategy for patients with unstable angina remains challenging, often resulting in unnecessary coronary angiography. Existing risk scores, including the GRACE and TIMI scores, were not designed to predict obstructive coronary artery disease. This study evaluated the predictive performance of a risk factor–weighted clinical likelihood model. Methods: This retrospective analytical cohort study included 150 patients with low-to intermediate-risk unstable angina who underwent coronary angiography at a tertiary hospital. Predictive accuracy was assessed using receiver operating characteristic analysis and compared with the Diamond Forrester, Fladseth, guideline-based criteria, GRACE, and TIMI scores. Obstructive disease was defined as significant stenosis or physiologically relevant lesions. Results: The prevalence of obstructive coronary disease was 60%. The model demonstrated superior discrimination, with an area under the curve of 0.885, which exceeded that of the comparator models. At a threshold score, 42.7% of angiographies were safely deferred, with a negative predictive value of 76.6%. Calibration improved after model adjustment. Conclusion: The risk factor–weighted clinical likelihood model provides a robust prediction of obstructive coronary artery disease in patients with unstable angina. This may support objective decision-making and enable a more selective invasive strategy, thereby reducing unnecessary procedures while maintaining diagnostic safety.
Co-Authors Achmad, Aziz Akbar, Nizam Zikri Andriyani, Yunilda Ardini, Tengku Winda Batubara , Gio Justisia Batubara, Gio Justisia Brahmana, Andrew Timanta Chan, Muhammad Ikhsan Cut Aria Arina Dewita, Auliya Dina Arwina Dalimunthe, Dina Arwina Faisal Adam, Faisal Faustine, Elaine Ferhat, Muhammad Ginting, Yehezkiel Habib, Faisal Hasan, Harris Hasan, Refli Haykal, T. Bob Hutapea, Mery Natalia Ilhami, Fadli Ilyas, Kamal Kharazzi Ilyas, Kamal Kharrazi Kesumawardani, Enggar Sari Ketaren, Andre Pasha Khaidirman, Sophia Khairina Khairul, Andi Lubis, Ahmad Feriansyah Lubis, Al-Ma’ Arij Akbar Lubis, Anggia Chairuddin Lubis, Hilfan Ade Putra Mukhtar, Zulfikri Napitupulu, Bertha Gabriela Napitupulu, Bertha Gabriella Nasution , Ali Nafiah Nasution, Ali Nafiah Purba, Joy Wulansari Putra, Muhammad Hafiz Mahruzza Raynaldo, Abdul Halim Reynaldo, Abdul Halim Rialdy, M. Isfan Rusdiana Rusdiana Safri, Zainal Sarastri, Yuke Sinaga, Akbar Siregar, Abdullah Afif Sitepu, Andika Tamba, Ratna Mariana Teuku Bob Haykal Yasmine Fitrina Siregar