Browsing by Autor "Santiago Callegari"

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A Case Series and Literature Review of Subacute Infective Endocarditis: A Clinical Challenge
(Cureus, Inc., 2023) Santiago Callegari; Alfredo Cabrera; Laura Mejía; Carlos A Sanchez
External Validation and Comparison of Two Clinical Prediction Models (PTP2013 and PTP2019) for Chest Pain in a Colombian Cohort
(2025) Nathaly Puentes; Ciro Rodríguez; Federico Ramos-Marquez; Diego A. Vargas-Hernández; Sergio Mauricio Moreno; L Guevara; Laura Rincón; Luz Karen Quintanilla Morales; Sílvia Paredes; Santiago Callegari
Abstract Aims The European Society of Cardiology (ESC) has proposed four pre-test probability (PTP) models for obstructive coronary artery disease (CAD). However, no studies have evaluated the diagnostic performance of any predictive model in the Latin American population. The aim of this study is to compare the PTP2013 and PTP2019 predictive models in order to determine which demonstrates a superior diagnostic performance for CAD in a cohort of Colombian patients. Methods A total of 408 patients who presented with chest pain and underwent coronary angiography (CA) and/or coronary computed tomography angiography (CCTA) at Fundación Santa Fe de Bogotá, between January 2019 and December 2023 were enrolled. Medical records were retrieved from the Hemodynamics and Radiology units. Pre-test probabilities were calculated for each patient using both the PTP2013 and PTP2019 models. CAD was defined as >50% stenosis on CA or CCTA. Each predictive model was assessed against CA and/or CCTA findings. The comparative performance of both models was evaluated. Results Prevalence of obstructive CAD of 24.9%. The PR2019 model underestimated the probability of CAD by 59%, whereas the PTP2013 model overestimated it by 35.6%. PTP2019 model yielded a C-statistic of 0.610 [95% CI: 0.544 - 0.676], while the PTP2013 model reported a C-statistic of 0.633 [95% CI: 0.570 - 0.696] (comparative p-value: 0.060). The net reclassification improvement was 14.7%). At a 15% threshold, the PTP2013 model demonstrated a sensitivity of 90% (82.38 - 95.10%), compared to 48% (37.9 - 58.22%) for the PTP2019 model. Conclusion The PTP2013 model is favored, as it showed higher sensitivity and a tendency to overestimate risk, in contrast to the PTP2019 model, which exhibited a concerning underdiagnosis of CAD. Consequently, the methodological challenge of identifying the predictive model with the highest diagnostic performance remains, highlighting the need to develop a tailored prediction model for the local population.
External validation of the ACC/AHA ASCVD risk score in a Colombian population cohort
(Nature Portfolio, 2023) Carlos Daniel Rodriguez Ariza; Alfredo Cabrera-Villamizar; Astrid Lorena Rodríguez-Pulido; Santiago Callegari; Natalia Rodriguez; Mónica Pinilla‐Roncancio; Sergio Moreno; Carlos A. Sánchez-Vallejo
No cardiovascular risk score has included Latin American patients in its development. The ACC/AHA ASCVD risk score has not been validated in Latin America; consequently, its predictive capacity in the population of the region is unknown. The aim of this study is to evaluate the discrimination capacity and calibration of the ACC/AHA ASCVD score to predict the 10-year risk of a cardiovascular event in a primary prevention cohort followed in a Colombian hospital. A retrospective cohort study was conducted in primary prevention patients belonging to an intermediate/high-risk and low-risk cohort without established atherosclerotic disease. Cardiovascular risk was calculated at inclusion. The calibration was analyzed by comparing observed and expected events in the different risk categories. A discrimination analysis was made using the area under the ROC curve and C statistic. A total of 918 patients were included-202 from the intermediate/high-risk and 716 from the low-risk cohort. The median cardiovascular risk was 3.6% (IQR 1.7-8.5%). At the 10-year follow-up, 40 events (4,4%) occurred. The area under the ROC curve was 0.782 (95% CI 0.71-0.85). The Hosmer-Lemeshow test did not show differences between expected and observed events. The ACC/AHA ASCVD score is calibrated and has good discrimination capacity in predicting 10-year risk of cardiovascular events in a Colombian population.