Positive predictive value for coronary artery disease improves with age, exercise responses
THURSDAY, Oct. 4 (HealthDay News) -- The positive predictive value (PPV) of the exercise treadmill test (ETT) for coronary artery disease (CAD) in women is altered significantly by age and certain exercise responses, according to a study published online Sept. 26 in The American Journal of Cardiology.
Jeffrey M. Levisman, M.D., the from University of California (Davis) Medical Center in Sacramento, and colleagues evaluated the diagnostic properties of the ETT in a group of 111 women with chest pain who had a positive ETT result and subsequent coronary angiography.
The researchers found that 56 women had significant CAD on angiogram, yielding a PPV of 51 percent for the group. The PPV of the ETT improved with inclusion of several pretest attributes and specific exercise test responses. The youngest group (35 to 50 years old) had a PPV of 36 percent, compared to 68 percent in women over 65 years of age. Across all age groups, ST-segment depression of more than 2 mm and delayed ST-segment recovery (>3.0 minutes) further separated true from false positives, increasing the PPV to approximately 80 percent.
"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," the authors write.
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