Predicting lesion complexity in premature coronary artery disease: The utility of clinical risk scores

Firdaus, Achmad Jauhar; Mohammad Saifur Rohman; Budi Satrijo; Cholid Tri Tjahjono; Anna Fuji Rahimah

doi:10.21776/ub.hsj.2025.006.03.12

Akses terbuka Jurnal SINTA 1

Predicting lesion complexity in premature coronary artery disease: The utility of clinical risk scores

Heart Science Journal · Vol. 6 No. 3 (2025)

DOI: 10.21776/ub.hsj.2025.006.03.12
ISSN: 2721-9984, 2721-9976
Terbit: 2025-07-31
Penerbit: Universitas Brawijaya
Bahasa: en
Lisensi: creativecommons.org/licenses/by/4.0

Abstrak

Background: Premature coronary artery disease (PCAD) has been recognized as a significant global health issue, with its prevalence increasing due to earlier exposure to various risk factors. Emerging evidence suggests that PCAD may be as aggressive, if not more so, than in older populations. The clinical implications and angiographic characteristics for more aggressive management strategies remain poorly explored. Objectives: This study aims to develop and validate a clinical scoring system in predicting lesion complexity in patients with PCAD. Methods: A retrospective cohort study was conducted on 645 patients who underwent invasive coronary angiography (ICA) from January 2023 to December 2024 in Dr. Saiful Anwar General Hospital, East Java, Indonesia. Patients were divided into developmental (n = 322) and validation (n = 323) groups. Clinical information was gathered from medical records, including risk factors and angiographic results. Predictors of complex CAD (SYNTAX ≥ 33) were identified by multiple logistic regression analysis. A clinical scoring system was developed and validated. Results: This study found complex CAD in 252 (39.1%) of all PCAD patients. Smoking (OR 2.3; p 0.006), dyslipidemia (OR 2.8; p < 0.001), diabetes mellitus (OR 3.9; p < 0.001), history of previous myocardial infarction (OR 6.5; p < 0.001), and family history of CAD (OR 5.7; p < 0.001) were independent predictors of complex CAD. A clinical scoring system was developed with a cut-off score ≥ 4 predicting complex CAD, with an area under the curve (AUC) value of 0.836 (95% CI 0.791-0.880), sensitivity of 71.3%, and specificity of 85.0%. Conclusion: The PCAD population continues to represent a high-risk group of concern. While the short-term prognosis is optimistic, the long-term outlook for this cohort is less promising due to the high recurrence rate and prolonged complications, especially in individuals with complicated CAD, leading to impaired quality of life

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University of Brawijaya
RSUD Prof. Dr. Saiful Anwar Malang
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Tampilkan sebagai tabel

Rekan penulis	Organisasi	Artikel bersama
Setyasih Anjarwani	University of Brawijaya	34
Anna Fuji Rahimah	University of Brawijaya	33
Indra Prasetya	University of Brawijaya	32
Novi Kurnianingsih	University of Brawijaya	32
Ardian Rizal	University of Brawijaya	26
Sasmojo Widito	University of Brawijaya	26
Djanggan Sargowo	University of Brawijaya	25
Heny Martini	University of Brawijaya	21
Yoga Waranugraha	University of Brawijaya	15
Muhammad Rizki Fadlan	University of Brawijaya	9
Dadang Hendrawan	University of Brawijaya	6
Wella Karolina	University of Brawijaya	6
Valerinna Yogibuana	Afiliasi tidak diketahui	6
Adhika Prastya Wikananda	University of Brawijaya	5
Tri Astiawati	University of Brawijaya	5
Putri Annisa Kamila	University of Brawijaya	5
Saskia Dyah Handari	University of Brawijaya	5
Ayu Asri Devi Adityawati	University of Brawijaya	5
Imelda Krisnasari	University of Brawijaya	5
Valerinna Yogibuana Swastika Putri	University of Brawijaya	5
Fandy Hazzy	University of Brawijaya	4
Hayla Iqda Millisani	University of Brawijaya	4
Tonny Adriyanto	University of Brawijaya	4
Olivia Handayani	University of Brawijaya	4
Ratna Pancasari	University of Brawijaya	4
Seprian Widasmara	University of Brawijaya	4
Teguh Aryanugraha	University of Brawijaya	4
Ira Vori Nugroho	University of Brawijaya	4
Oktivani Adelathifa Rahma	University of Brawijaya	3
Veny Kurniawati	University of Brawijaya	3
Fahmy Rusnanta	University of Brawijaya	3
Shalahuddin Suryo Baskoro	University of Brawijaya	3
Nikhen Noverike	University of Brawijaya	3
Zhafran Veliawan	University of Brawijaya	3
Jonny Karunia Fajar	University of Brawijaya	2

Afiliasi berasal dari OpenAlex; metadata OAI-PMH jurnal tidak memuatnya. Penulis tanpa ID OpenAlex dicocokkan berdasarkan nama, sehingga dua orang bisa tergabung atau satu orang bisa terpisah.

Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.

Metadata asli (oai_dc)

<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Predicting lesion complexity in premature coronary artery disease: The utility of clinical risk scores</dc:title>
	<dc:creator xml:lang="en">Firdaus, Achmad Jauhar</dc:creator>
	<dc:creator xml:lang="en">Mohammad Saifur Rohman</dc:creator>
	<dc:creator xml:lang="en">Budi Satrijo</dc:creator>
	<dc:creator xml:lang="en">Cholid Tri Tjahjono</dc:creator>
	<dc:creator xml:lang="en">Anna Fuji Rahimah</dc:creator>
	<dc:subject xml:lang="en">Premature Coronary Artery Disease</dc:subject>
	<dc:subject xml:lang="en">Complex CAD</dc:subject>
	<dc:subject xml:lang="en">SYNTAX</dc:subject>
	<dc:subject xml:lang="en">Clinical Score</dc:subject>
	<dc:description xml:lang="en">Background: Premature coronary artery disease (PCAD) has been recognized as a significant global health issue, with its prevalence increasing due to earlier exposure to various risk factors. Emerging evidence suggests that PCAD may be as aggressive, if not more so, than in older populations. The clinical implications and angiographic characteristics for more aggressive management strategies remain poorly explored.
Objectives: This study aims to develop and validate a clinical scoring system in predicting lesion complexity in patients with PCAD.
Methods: A retrospective cohort study was conducted on 645 patients who underwent invasive coronary angiography (ICA) from January 2023 to December 2024 in Dr. Saiful Anwar General Hospital, East Java, Indonesia. Patients were divided into developmental (n = 322) and validation (n = 323) groups. Clinical information was gathered from medical records, including risk factors and angiographic results. Predictors of complex CAD (SYNTAX ≥ 33) were identified by multiple logistic regression analysis. A clinical scoring system was developed and validated.
Results: This study found complex CAD in 252 (39.1%) of all PCAD patients. Smoking (OR 2.3; p 0.006), dyslipidemia (OR 2.8; p &amp;lt; 0.001), diabetes mellitus (OR 3.9; p &amp;lt; 0.001), history of previous myocardial infarction (OR 6.5; p &amp;lt; 0.001), and family history of CAD (OR 5.7; p &amp;lt; 0.001) were independent predictors of complex CAD. A clinical scoring system was developed with a cut-off score ≥ 4 predicting complex CAD, with an area under the curve (AUC) value of 0.836 (95% CI 0.791-0.880), sensitivity of 71.3%, and specificity of 85.0%.
Conclusion: The PCAD population continues to represent a high-risk group of concern. While the short-term prognosis is optimistic, the long-term outlook for this cohort is less promising due to the high recurrence rate and prolonged complications, especially in individuals with complicated CAD, leading to impaired quality of life</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2025-07-31</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20410</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2025.006.03.12</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visualization</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2025.006.03</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20410/510</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2025 Achmad Jauhar Firdaus, Mohammad Saifur Rohman, Budi Satrijo, Cholid Tri Tjahjono, Anna Fuji Rahimah</dc:rights>
	<dc:rights xml:lang="en">http://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>