Document Detail

Improving the Positive Predictive Value of Exercise Testing in Women for Coronary Artery Disease.
MedLine Citation:
PMID:  23018079     Owner:  NLM     Status:  Publisher    
The exercise treadmill test (ETT) in women has been limited by a low positive predictive value (PPV) for coronary artery disease (CAD). However, the reliability of previous studies was unsatisfactory because of the inclusion of younger women with a low prevalence of CAD. To further evaluate the diagnostic properties of the ETT in women, we evaluated a group of women with chest pain who had a positive ETT result and subsequent coronary angiography. Of the 111 women, 56 had significant CAD on angiogram, yielding a PPV of 51% for the group. However, inclusion in the analysis of several pretest attributes and specific exercise test responses improved the PPV of the ETT. Age had a major effect, with the youngest group (35 to 50 years old) having a PPV of 36% compared to 68% in the oldest group (>65 years old). Several specific exercise responses (ST-segment depression >2 mm and delayed ST-segment recovery >3.0 minutes) further separated true from false positives across all age groups, increasing the PPV to approximately 80%. Onset of ischemia at a relatively low cardiac workload of <80% maximum predicted heart rate was not a significant predictor. In conclusion, the standard ETT should remain the test of choice in ambulatory women with chest pain and no significant abnormalities on baseline electrocardiogram especially in those >65 years of age.
Jeffrey M Levisman; Karen Aspry; Ezra A Amsterdam
Related Documents :
7061689 - Ultrastructural and biochemical characterization of human brown adipose tissue in pheoc...
17102979 - Effects of adaptive exercise on apoptosis in cells of rat renal tubuli.
536299 - Maximum oxygen consumption of rats and its changes with various experimental procedures.
9805099 - Skeletal muscle na+/h+ exchange in rats: ph dependency and the effect of training.
10232069 - Effects of a standardized panax ginseng extract on the skeletal muscle of the rat: a co...
17084969 - Central nitric oxide inhibition modifies metabolic adjustments induced by exercise in r...
18425829 - Determining exercise-induced blood flow reserve in lower extremities using phase contra...
10460479 - Functional analysis of articular cartilage deformation, recovery, and fluid flow follow...
6789029 - Effects of exercise on protein and amino acid metabolism.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-24
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Division of Cardiovascular Medicine, University of California (Davis) Medical Center, Sacramento, California.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  De Garengeot's hernia: an unusual right groin mass due to acute appendicitis in an incarcerated femo...
Next Document:  Clinical screening tests for assessing movement control in non-specific low-back pain. A systematic ...