15283-B-Blokker

105 Accuracy of MIA for the detection of ischemic heart disease 6 Statistical analysis Analyses were performed on the patient level. Conventional autopsy was used as the reference standard. We calculated sensitivity and specificity and 95% confidence intervals for the detection of acute and chronic MI for MRI and for MIA (MRI, CT and biopsies). Confidence intervals for sensitivity and specificity are Clopper-Pearson confidence intervals. 160 Inter-observer agreement was calculated using kappa statistics. Calculations were performed using IBM® SPSS® Statistics version 21. ROC curves We calculated ROC curves to investigate diagnostic value of CT (Total Agatston calcium score), MRI and biopsies for diagnosing acute and chronic myocardial infarction. In the analysis the diagnostic value (sensitivity and specificity and ROC curves) of biopsies was combined with MRI, because biopsies were taken from radiologically suspect areas, identified at MRI. RESULTS Case recruitment From January 2012 to December 2014, 100 consecutive cases (62 men, 38 women) were included in the study. One case was excluded because autopsy findings warranted a forensic autopsy. The mean interval between death and start of imaging was 23.2±15.6 hours (range: 3.2-71.6). Mean age at the time of death was 62.5 years (range: 25-92). In the group with clinical suspicion of ischemic heart disease 14/30 (46%) patients were admitted to the hospital with out-of-hospital cardiac arrest vs 3/69 (4%) in the group without clinical suspicion of cardiac death. Agreement between clinical suspicion and autopsy findings In the group with a clinical suspicion of ischemic heart disease as the cause of death, acute MI was found in 16/30 (53.3%) of cases by conventional autopsy. In the group without clinical suspicion of ischemic heart disease as the cause of death, acute MI was found in 18/69 (26.1%) cases. Twenty-two of the 34 cases with acute myocardial infarction found with conventional autopsy had no known ischemic heart disease during life. Twenty cases had clinically known ischemic heart disease during life (at least one ischemic episode during life, determined by clinicians). Myocardial infarction, either chronic or acute, was confirmed by conventional autopsy and MIA in 16/20 of these cases (the same cases were identified with MIA and conventional autopsy).