ArticleHeart (British Cardiac Society)1996
Women with chest pain: is exercise testing worthwhile?
Article in Heart (British Cardiac Society), 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison of a two-lead, computerized, resting ECG signal analysis device, the MultiFunction-CardioGram or MCG (a.k.a. 3DMP), to quantitative coronary angiography for the detection of relevant coronary artery stenosis (>70%) - a meta-analysis of all published trials performed and analyzed in the US.International journal of medical sciences · 2009Pooled it
- Gender-based prognostic value of pharmacological cardiac magnetic resonance stress testing: head-to-head comparison of adenosine perfusion and dobutamine wall motion imaging.The international journal of cardiovascular imaging · 2012Article
- Electrocardiographic body surface mapping: potential tool for the detection of transient myocardial ischemia in the 21st century?Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2009Review
- Sex differences in use of interventional cardiology persist after risk adjustment.Journal of epidemiology and community health · 2009Article
- Carotid intima-media thickness in pre- and postmenopausal women with suspected coronary artery disease.Heart and vessels · 2008Article
- Computerized two-lead resting ECG analysis for the detection of coronary artery stenosis after coronary revascularization.International journal of medical sciences · 2008Article
- Computerized two-lead resting ECG analysis for the detection of coronary artery stenosis.International journal of medical sciences · 2007Article
- TIMI risk score: does it work equally well in both males and females?Emergency medicine journal : EMJ · 2007Article
- Narrowing gender differences in procedure use for acute myocardial infarction: insights from the Worcester heart attack study.Journal of general internal medicine · 2003Article
- A prioritisation system for elective coronary angiography.Heart (British Cardiac Society) · 1998Article
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8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the diagnostic value of the exercise tolerance test (ETT) in women presenting with chest pain.
designProspective study of all women presenting to a centre with chest pain between 1987 and 1993 who were assessed by an ETT and coronary angiography.
settingThe outpatient clinic of one consultant cardiologist in a tertiary referral centre. PATIENTS: All women referred to this outpatient clinic with chest pain were screened. For inclusion, patients had to perform ETT and undergo coronary angiography. Of the 347 referred during this period, 142 were excluded because they were unable to perform ETT or because of Q waves or other abnormalities on their resting electrocardiogram.
resultsOverall the sensitivity of the ETT was 68% and the specificity was 61%, with a positive predictive value of 0.61 and a negative predictive value of 0.68. There were 42 false positive and 31 false negative ETT results (36% of the study group). The predictive value of a negative test was higher in younger women (< 52 years) than in the older group (> or = 52 years) (P = 0.004), but the positive predictive value in the two groups was not significantly different. The predictive value of a negative test was also higher in those with two or fewer risk factors than in those with three or more risk factors (P = 0.001). The negative predictive value for those women above 52 years with three or more risk factors (24% of the study group) was only 0.25. Lack of chest pain during ETT was associated with a higher negative predictive value in the younger group than in the older women (P = 0.006).
conclusionsIn women with chest pain use of the ETT was a misleading predictor of the presence or absence of coronary disease in 36% of these patients. In particular, a negative test in older women with three or more risk factors had a very low predictive value. The inclusion of risk factors and division by age can, however, be used to identify a population at intermediate risk for coronary artery disease in whom the ETT result has the highest diagnostic utility.
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