Document Detail


The accuracy of noninvasive stress myocardial imaging for detecting coronary artery disease in clinical practice.
MedLine Citation:
PMID:  20469609     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is a wide variation in reported accuracy ofnoninvasive stress myocardial imaging as a screening tool for coronary artery disease (CAD). This study was undertaken to determine its current accuracy in a wide spectrum of patients with chest pain syndromes using invasive coronary angiography as the gold standard.
METHODS: The patient population consisted of consecutive patients undergoing coronary angiography in whom noninvasive stress imaging, either nuclear or echocardiographic, was performed within 6 months prior to the angiogram. The specificity, sensitivity, positive and negative predictive values, and diagnostic accuracy for detecting > or =1 lesions with > or =50% diameter coronary stenosis were determined for each modality.
RESULTS: Of the 227 eligible patients, 141 were men and 86 were women; 70% had significant CAD. The diagnostic accuracy overall was 71% and was no different for nuclear or echocardiographic testing. The positive predictive value (86% vs. 52%; P = 0.002) and diagnostic accuracy (83% vs. 51%; P = 0.002) were better in men than in women.
INTERPRETATION: In this study, noninvasive stress imaging lacked the accuracy of a good screening test for significant CAD. This finding was particularly true for women, for whom it was not much better than a coin toss.
Authors:
Leonard Schwartz; Christopher B Overgaard
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Hospital practice (1995)     Volume:  38     ISSN:  2154-8331     ISO Abbreviation:  Hosp Pract (1995)     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-08-04     Revised Date:  2013-04-10    
Medline Journal Info:
Nlm Unique ID:  101268948     Medline TA:  Hosp Pract (1995)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  14-8     Citation Subset:  AIM; IM    
Affiliation:
Toronto General Hospital, Toronto, ON, Canada. Dr.Leonard.Schwartz@uhn.on.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Coronary Angiography* / standards
Coronary Artery Disease / diagnosis*,  epidemiology
Echocardiography* / standards
Exercise Test* / standards
False Positive Reactions
Female
Humans
Male
Mass Screening / methods*,  standards
Middle Aged
Ontario / epidemiology
Patient Selection
Predictive Value of Tests
Prevalence
Sensitivity and Specificity
Sex Distribution
Tomography, Emission-Computed, Single-Photon* / standards

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


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