Establishing a Coronary Angiography Jeopardy Score for Myocardial Risk Assessment: A Comparison with the Duke Treadmill Score

Abstract

Objectives: The Exercise Tolerance Test (ETT) is widely used to identify high-risk subgroups in patients with coronary artery disease (CAD). The Duke Treadmill Score (DTS) is a validated non-invasive prognostic tool that assesses the severity of CAD and helps predict cardiovascular outcomes. In this study, we propose a novel Coronary Angiography Jeopardy Score (CAJS) designed to enhance prognostic accuracy in patients with chronic stable angina (CSA) classes II-III by integrating DTS and coronary angiography findings. Methodology: This prospective observational study involved 86 consecutive patients admitted to Al Diwaniyah Teaching Hospital and Al Diwaniyah Center of Heart Diseases between January 2017 and February 2018. All participants had high-risk positive ETT results, and their Duke Treadmill Scores were calculated. Following this, coronary angiography was performed, and the CAJS was established for each patient. Patients were categorized into three groups based on the predominant stenotic artery. The mean CAJS and DTS for each group were calculated and statistically compared using an F-distribution table, p-value, and Pearson correlation coefficient to evaluate any significant correlation between the two scoring systems. Results: A total of 86 patients were included in the analysis. Our findings revealed a statistically significant association between the mean DTS and the corresponding mean CAJS for each group. This correlation supports the validity of CAJS as a reliable invasive prognostic tool in assessing myocardial risk in CAD patients. Conclusion: The newly proposed CAJS provides a clinically relevant and invasive prognostic method that enhances risk stratification beyond the DTS alone. It offers valuable prognostic insights for patients with CSA classes II-III, contributing to more informed clinical decision-making.