The use of basic clinical and exercise variables in postmenopausal women for the diagnosis of coronary artery disease

Abstract

The diagnostic utility of clinical and exercise parameters in women with possible coronary artery disease are underestimated and considered unreliable, in most cases. This seems to be mainly due to the lower likelihood of the disease in selected populations. In this study, postmenopausal women with variable clinical and exercise parameters were tried to be correlated with significant coronary artery disease. One hundred twenty patients with atherosclerotic risk factors, typical angina, or atypical chest pain with ischemic ECG changes were involved. All patients underwent exercise stress test, and 110 suitable patients had coronary angiography. Nonsignificant and significant coronary stenoses (50% narrowing, at least) were investigated due to the parameters involved. Single vessel disease was detected as the most extensive form of the disease, whereas significant lesions correlated only with diabetes, peripheral artery disease, multiple risk factors, typical angina at exercise, insufficient maximum workload, and early ST/T changes. A positive predictive value of 78.5% and a negative predictive value of 80% were determined. The diagnosis of significant coronary artery disease, using basic parameters, is similar to that of men, provided that factors leading to lower likelihood of the disease are excluded. This is a contrasting result with earlier studies which imply unreliable results attributable to female gender.