Noninvasive diagnostic test choices for the evaluation of coronary artery disease in women: a multivariate comparison of cardiac fluoroscopy, exercise electrocardiography and exercise thallium myocardial perfusion scintigraphy
Several diagnostic noninvasive tests to detect coronary and multivessel coronary disease are available for women. However, all are imperfect and it is not yet clear whether one particular test provides substantially more information than others. The aim of this study was to evaluate clinical findings, exercise electrocardiography, exercise thallium myocardial scintigraphy and cardiac fluoroscopy in 92 symptomatic women without previous infarction and determine which tests were most useful in determining the presence of coronary disease and its severity. Univariate analysis revealed two clinical, eight exercise electrocardiographic, seven myocardial scintigraphic and seven fluoroscopic variables predictive of coronary or multivessel disease with 70% or greater stenosis. The multivariate discriminant function analysis selected a reversible thallium defect, coronary calcification and character of chest pain syndrome as the variables most predictive of presence or absence of coronary disease. The ranked order of variables most predictive of multivessel disease were cardiac fluoroscopy score, thallium score and extent of ST segment depression in 14 electrocardiographic leads. Each provided statistically significant information to the model. The estimate of predictive accuracy was 89% for coronary disease and 97% for multivessel coronary disease. The results suggest that cardiac fluoroscopy or thallium scintigraphy provide significantly more diagnostic information than exercise electrocardiography in women over a wide range of clinical patient subsets.
- Research Organization:
- Montreal Heart Inst., Quebec, Canada
- OSTI ID:
- 6132856
- Journal Information:
- J. Am. Coll. Cardiol.; (United States), Vol. 4:1
- Country of Publication:
- United States
- Language:
- English
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CARDIOGRAPHY
COMPARATIVE EVALUATIONS
CARDIOVASCULAR DISEASES
DIAGNOSIS
FLUOROSCOPY
SCINTISCANNING
BLOOD VESSELS
ELECTROCARDIOGRAMS
EXERCISE
MULTIVARIATE ANALYSIS
MYOCARDIUM
PATIENTS
SYMPTOMS
THALLIUM ISOTOPES
WOMEN
ANIMALS
BIOMEDICAL RADIOGRAPHY
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DIAGRAMS
DISEASES
FEMALES
HEART
ISOTOPES
MAMMALS
MAN
MATHEMATICS
MEDICINE
MUSCLES
NUCLEAR MEDICINE
ORGANS
PRIMATES
RADIOISOTOPE SCANNING
RADIOLOGY
STATISTICS
VERTEBRATES
550601* - Medicine- Unsealed Radionuclides in Diagnostics