Document Detail

Comparative study to assess whether high sensitive C-reactive protein and carotid intima media thickness improve the predictive accuracy of exercise stress testing for coronary artery disease in perimenopausal women with typical angina.
MedLine Citation:
PMID:  18705250     Owner:  NLM     Status:  MEDLINE    
Anginal symptoms are less predictive of abnormal coronary anatomy in women. The diagnostic accuracy of exercise treadmill test for obstructive coronary artery disease is less in young and middle aged women. High sensitive C-reactive protein has shown a strong and consistent relationship to the risk of incident cardiovascular events. Carotid intima media thickness is a non-invasive marker of atherosclerosis burden and also predicts prognosis in patients with coronary artery disease. We investigated whether incorporation of high sensitive C-reactive protein and carotid intima media thickness along with exercise stress results improved the predictive accuracy in perimenopausal non-diabetic women subset. Fifty perimenopausal non-diabetic patients (age 45 +/- 7 years) presenting with typical angina were subjected to treadmill test (Bruce protocol). Also carotid artery images at both sides of neck were acquired by B-mode ultrasound and carotid intima media thickness were measured. High sensitive C-reactive protein was measured. Of 50 patients, 22 had a positive exercise stress result. Coronary angiography done in all 50 patients revealed coronary artery disease in 10 patients with positive exercise stress result and in 4 patients with negative exercise stress result. Treadmill exercise stress test had a sensitivity of 71.4%, specificity of 66.7% and a negative predictive accuracy of 85.7% in this study group. High sensitive C-reactive protein in patients with documented coronary artery disease was not significantly different from those without coronary artery disease (4.8 +/- 0.9 mg/l versus 3.9 +/- 1.7 mg/l, p=NS). Also carotid intima media thickness was not significantly different between either of the groups with coronary artery disease positivity and negativity respectively (left: 1.25 +/- 0.55 versus 1.20 +/- 0.51 mm, p=NS; right:1.18 +/- 0.54 versus 1.15 +/- 0.41 mm, p=NS). High sensitive C-reactive protein and carotid intima media thickness were not helpful in further adding to the predictability of coronary artery disease in perimenopausal patients with typical angina as assessed by treadmill exercise stress test.
Dhurjati Prasad Sinha; Munna Das; Amal Kumar Banerjee; Shageer Ahmed; Sonali Majumdar
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the Indian Medical Association     Volume:  106     ISSN:  0019-5847     ISO Abbreviation:  J Indian Med Assoc     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-08-18     Completed Date:  2008-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7505608     Medline TA:  J Indian Med Assoc     Country:  India    
Other Details:
Languages:  eng     Pagination:  86, 88, 90 passim     Citation Subset:  IM    
Cardiology Division, Institute of Cardiovascular Sciences, Institute of Postgraduate Medical Education and Research and SSKM Hospital, Kolkata.
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MeSH Terms
Angina Pectoris / blood,  diagnosis
C-Reactive Protein / metabolism*
Carotid Arteries / ultrasonography*
Coronary Angiography
Coronary Disease / blood,  diagnosis*
Diagnosis, Differential
Exercise Test / methods*
Follow-Up Studies
Middle Aged
Nephelometry and Turbidimetry
Predictive Value of Tests
Reproducibility of Results
Tunica Intima / ultrasonography
Reg. No./Substance:
9007-41-4/C-Reactive Protein

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