Abstract 20663: Accuracy of Exercise Stress Testing to Diagnose Coronary Heart Disease in Women
Background: The 2012 ACCF/AHA guidelines report that the diagnostic sensitivity and specificity of exercise stress ECG is lower in women than men. We compare the outcomes of stress ECG in a community based setting in a ethnically diverse,
Methods/Results: The study cohort is comprised of 600 consecutive subjects, 284 women and 313 men, who underwent symptom-limited stress ECG using the Bruce protocol for clinical indications. Clinical status at 3 months after stress test was determined in 569 pts (94.8%). The mean age for women and men was 53.7 ±13.5 and 53.8 ±14.4 years (p=0.79) respectively. 33% of subjects were non-caucasian. There was no significant difference between the two groups in the prevalence of exercise routines prior to testing (p=.32). Women had significantly lower total exercise time, 8:18 min vs 10:12 min (p<0.001) and maximum METS achieved, 10.2 vs 12.0 METS (p=0.15) Maximum heart rate achieved was similar in both groups, 160 ±23 vs 162 ± 20 bpm (p= .30). Diagnostic ECG changes consistent with ischemia occurred in 14.1% of women vs 14.4% of men (P=.917). Subsequent testing in 103 subjects demonstrated ischemia in 3 subjects. Coronary angiography after stress testing demonstrated obstructive CAD in 2 patients. 1 patient had coronary angiography directly after stress ECG and underwent CABG. The specificity of a positive stress ECG was 0.86 in women and 0.85 in men. The AUC is 0.93 for both men and women.
Conclusions: In a clinically selected cohort of patients undergoing stress ECG, the accuracy of stress ECG in diagnosing cardiac ischemia is similar between men and women.
Author Disclosures: H.A. Tran: None. M. Lui: None. S. Gupta: None. N. Badoe: None. S. Tewolde: None. L. Evans: None.
- © 2016 by American Heart Association, Inc.