{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:55:11Z","timestamp":1755795311418,"version":"3.44.0"},"reference-count":23,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T00:00:00Z","timestamp":1601856000000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2020,9,2]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To prospectively validate the CT-Valve score, a new risk score designed to identify patients with valvular heart disease at a low risk of coronary artery disease (CAD) who could benefit from multislice CT (MSCT) first instead of coronary angiography (CAG).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a prospective cohort study of patients referred for valve surgery in the Capital Region of Denmark and Odense University Hospital from the 1 February 2015 to the 1 February 2017. MSCT was implemented for patients with a CT-Valve score \u22647 at the referring physician\u2019s discretion. Patients with a history of CAD or chronic kidney disease were excluded. The primary outcome was the proportion of patients needing reevaluation with CAG after MSCT and risk of CAD among the patients determined to be low to intermediate risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 1149 patients were included. The median score was 9 (IQR 3) and 339 (30%) had a score \u22647. MSCT was used for 117 patients. Of these 29 (25%) were reevaluated and 9 (7.7%) had CAD. Of the 222 patients with a score \u22647\u2009that did not receive an MSCT, 14 (6%) had significant CAD. The estimated total cost of evaluation among patients with a score \u22647 before implementation was \u20ac132 093 compared with \u20ac79 073 after, a 40% reduction. Similarly, estimated total radiation before and after was 608\u2009mSv and 362\u2009mSv, a 41% reduction. Follow-up at a median of 32 months (18\u201348) showed no ischaemic events for patients receiving only MSCT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The CT-Valve score is a valid method for determining risk of CAD among patients with valvular heart disease. Using a score \u22647 as a cut-off for the use of MSCT is safe and cost-effective.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2020-001380","type":"journal-article","created":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T17:29:01Z","timestamp":1601918941000},"page":"e001380","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4274-6268","authenticated-orcid":false,"given":"Rasmus Bo","family":"Hasselbalch","sequence":"first","affiliation":[{"name":"Department of Cardiology, Herlev Hospital, Herlev, Denmark"},{"name":"Department of Emergency Medicine, Herlev Hospital, Herlev, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mia Marie","family":"Pries-Heje","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev Hospital, Herlev, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Louise","family":"Kj\u00f8lhede Holle","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev Hospital, Herlev, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Engstr\u00f8m","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merete","family":"Heitmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frants","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morten","family":"Schou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev Hospital, Herlev, Denmark"},{"name":"Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans","family":"Mickley","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Odense University Hospital, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanne","family":"Elming","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Roskilde Hospital, Roskilde, Sjaelland, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf","family":"Steffensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nephrology and Endocrinology, Nordsjaellands Hospital, Hilleroed, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Koeber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kasper","family":"Iversen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev Hospital, Herlev, Denmark"},{"name":"Department of Emergency Medicine, Herlev Hospital, Herlev, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,10,5]]},"reference":[{"key":"2025081711112735000_7.2.e001380.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2014.03.022"},{"key":"2025081711112735000_7.2.e001380.2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi471"},{"key":"2025081711112735000_7.2.e001380.3","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx391"},{"key":"2025081711112735000_7.2.e001380.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.05.014"},{"key":"2025081711112735000_7.2.e001380.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.09.028"},{"key":"2025081711112735000_7.2.e001380.6","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ijcard.2016.11.078","article-title":"Coronary risk stratification of patients undergoing surgery for valvular heart disease","volume":"227","author":"Hasselbalch","year":"2017","journal-title":"Int J Cardiol"},{"key":"2025081711112735000_7.2.e001380.7","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.10100384"},{"key":"2025081711112735000_7.2.e001380.8","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1093\/oxfordjournals.rpd.a006466","article-title":"Effective dose to a patient undergoing coronary angiography","volume":"94","author":"Lobotessi","year":"2001","journal-title":"Radiat Prot Dosimetry"},{"key":"2025081711112735000_7.2.e001380.9","first-page":"1","article-title":"64-slice computed tomographic angiography for the diagnosis of intermediate risk coronary artery disease: an evidence-based analysis","volume":"10","author":"Budoff MJ","year":"2010","journal-title":"Ont Health Technol Assess Ser"},{"key":"2025081711112735000_7.2.e001380.10","doi-asserted-by":"publisher","DOI":"10.3310\/hta17370"},{"key":"2025081711112735000_7.2.e001380.11","unstructured":"Statens Serum Institut . Prices of procedures (Takstsystem) 2014."},{"key":"2025081711112735000_7.2.e001380.12","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-300149"},{"key":"2025081711112735000_7.2.e001380.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2008.10.013"},{"key":"2025081711112735000_7.2.e001380.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2015.02.008"},{"key":"2025081711112735000_7.2.e001380.15","unstructured":"Goverment offices of Sweden . Swedish agency for health technology assessment and assessment of social services (Statens beredning f\u00f6r medicinsk och social utv\u00e4rdering). coronary angiography for suspected coronary disease (Datortomografi f\u00f6r misst\u00e4nkt kransk\u00e4rlssjukdom). SBU Alert-Rapport; 2011."},{"key":"2025081711112735000_7.2.e001380.16","unstructured":"R Core Team . R: a language and Eviroment for statistical computing 2016."},{"key":"2025081711112735000_7.2.e001380.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69208-8"},{"key":"2025081711112735000_7.2.e001380.18","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.athoracsur.2018.10.004","article-title":"The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2019 Update on Outcomes and Quality","volume":"107","author":"D'Agostino","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2025081711112735000_7.2.e001380.19","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.ijcard.2012.09.057","article-title":"Assessment of coronary artery disease using coronary computed tomography angiography in patients with aortic valve stenosis referred for surgical aortic valve replacement","volume":"168","author":"Larsen","year":"2013","journal-title":"Int J Cardiol"},{"key":"2025081711112735000_7.2.e001380.20","first-page":"65","article-title":"Risks and complications of coronary angiography: a comprehensive review","volume":"4","author":"Tavakol","year":"2012","journal-title":"Glob J Health Sci"},{"key":"2025081711112735000_7.2.e001380.21","article-title":"Quality assurance of the Western Denmark heart registry, a population-based healthcare register","volume":"64","author":"Rasmussen","year":"2017","journal-title":"Dan Med J"},{"key":"2025081711112735000_7.2.e001380.22","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.15305"},{"key":"2025081711112735000_7.2.e001380.23","doi-asserted-by":"crossref","DOI":"10.1007\/s12410-017-9412-6","article-title":"The updated NICE guidelines: cardiac CT as the first-line test for coronary artery disease","volume":"10","author":"Moss","year":"2017","journal-title":"Curr Cardiovasc Imaging Rep"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2020-001380","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T18:11:35Z","timestamp":1755454295000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2020-001380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,10,5]]},"published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1136\/openhrt-2020-001380"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2020-001380","relation":{},"ISSN":["2053-3624"],"issn-type":[{"type":"electronic","value":"2053-3624"}],"subject":[],"published":{"date-parts":[[2020,10]]}}}