Assessment of coronary artery disease in women by dobutamine stress echocardiography: Comparison with stress thallium-201 single-photon emission computed tomography and exercise electrocardiography

Ho, Yi‐Lwun; Wu, Cho‐Kai; Huang, Pei‐Hsin; Lin, Lung-Chun; Chieng, Poon-Ung; Chen, Wen‐Jone; Chen, Ming-Fong; Lee, Yuan‐Teh

doi:10.1016/s0002-8703(98)70282-0

Cited by 56 publications

(19 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…70 On the basis of the aggregate data available in studies of nearly 1000 women with suspected CAD, stress echocardiography has demonstrated good diagnostic accuracy for detecting or excluding significant CAD, with a mean sensitivity of 81% (89% in women with multivessel disease), a specificity of 86%, and overall accuracy of 84%. 27,[33][34][35][37][38][39]67,69,[71][72][73][74][75][76][77][78] There appears to be no significant sex effect on the diagnostic accuracy of exercise echocardiography; thus, interpretation is sex neutral and equally accurate for women and men. Most stress echocardiography studies have not corrected for posttest referral bias, however; the few studies that have attempted to correct for posttest verification bias [33][34][35]71 demonstrate decreased sensitivity and increased specificity in identifying coronary artery disease as compared with unadjusted data.…”

Section: Diagnosismentioning

confidence: 99%

Role of Noninvasive Testing in the Clinical Evaluation of Women With Suspected Coronary Artery Disease

Mieres¹,

Shaw²,

Arai³

et al. 2005

Circulation

408

166

View full text Add to dashboard Cite

Abstract-Cardiovascular disease is the leading cause of mortality for women in the United States. Coronary heart disease, which includes coronary atherosclerotic disease, myocardial infarction, acute coronary syndromes, and angina, is the largest subset of this mortality, with Ͼ240 000 women dying annually from the disease. Atherosclerotic coronary artery disease (CAD) is the focus of this consensus statement. Research continues to report underrecognition and underdiagnosis of CAD as contributory to high mortality rates in women. Timely and accurate diagnosis can significantly reduce CAD mortality for women; indeed, once the diagnosis is made, it does appear that current treatments are equally effective at reducing risk in both women and men. As such, noninvasive diagnostic and prognostic testing offers the potential to identify women at increased CAD risk as the basis for instituting preventive and therapeutic interventions. Nevertheless, the recent evidence-based practice program report from the Agency for Healthcare Research and Quality noted the paucity of women enrolled in diagnostic research studies. Consequently, much of the evidence supporting contemporary recommendations for noninvasive diagnostic studies in women is extrapolated from studies conducted predominantly in cohorts of middle-aged men. The majority of diagnostic and prognostic evidence in cardiac imaging in women and men has been derived from observational registries and referral populations that are affected by selection and other biases. Thus, a better understanding of the potential impact of sex differences on noninvasive cardiac testing in women may greatly improve clinical decision making. This consensus statement provides a synopsis of available evidence on the role of the exercise ECG and cardiac imaging modalities, both those in common use as well as developing technologies that may add clinical value to the diagnosis and risk assessment of the symptomatic and asymptomatic woman with suspected CAD. (Circulation. 2005;111:682-696.)Key Words: AHA Scientific Statements Ⅲ women Ⅲ coronary disease Ⅲ imaging Ⅲ exercise testing C ardiovascular disease is the leading cause of mortality for women in the United States. Coronary heart disease, which includes coronary atherosclerotic disease, myocardial infarction (MI), acute coronary syndromes, and angina, is the largest subset of this mortality. Atherosclerotic coronary artery disease (CAD) is the focus of this consensus document. Although US men have experienced a decline in CAD deaths, the number of coronary deaths in women, Ͼ240 000 annually, has remained stable or has increased, depending on the study referenced. 1,2 CAD, which increases with advancing age, also is a substantial cause of morbidity and disability for US women. 3 Women, in particular young women (Ͻ55 years), have a worse prognosis from acute MI than their male counterparts, with a greater recurrence of MI and higherThe American Heart Association makes every effort to avoid any actual or potential conflicts of interest that ma...

show abstract

Section: Diagnosismentioning

confidence: 99%

Role of Noninvasive Testing in the Clinical Evaluation of Women With Suspected Coronary Artery Disease

Mieres¹,

Shaw²,

Arai³

et al. 2005

Circulation

408

166

View full text Add to dashboard Cite

show abstract

“…38,39 The accuracy of perfusion imaging appears to be decreased in women with breast tissue attenuation, 39 and the smaller LV chamber size in women. 40 Pooled data from three direct comparisons [41][42][43] revealed a comparable sensitivity of the two techniques (71 vs 80%, Pϭns) (175 patients, Table 2) with a higher specificity of stress echocardiography for the detection of coronary artery disease (72 vs 89%, P<0.01). Comparative studies on adenosine stress imaging in patients with hypertension and women are not available.…”

Section: Detection Of Coronary Artery Diseasementioning

confidence: 99%

Noninvasive evaluation of ischaemic heart disease: myocardial perfusion imaging or stress echocardiography?

Schinkel

Bax

Geleijnse

et al. 2003

European Heart Journal

159

View full text Add to dashboard Cite

“…Studies have reported on heterogeneous populations since patients with previous myocardial infarction or known CAD had been included. [14][15][16] To our knowledge, this is the first study in which DOBE has been compared directly with EX, DIPE, and SCINT on an homogeneous consecutive group of women with chest pain and no previous history of CAD.…”

Section: Discussionmentioning

confidence: 99%

“…The sensitivity and specificity obtained in this study are comparable with those obtained in previous studies performed on women. [14][15][16] Recently, the Women's Ischemia Syndrome Evaluation (WISE) group has reported on a striking overall sensitivity of 21% for DOBE in women without baseline wallmotion abnormalities. 17 This is in disagreement with other studies whose cohort is composed predominantly of men 11,12 or exclusively women.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Dobutamine stress echocardiography in the diagnosis of coronary artery disease in women with chest pain: Comparison with different noninvasive tests

Rollán

Román

Vilacosta

et al. 2002

Clinical Cardiology

View full text Add to dashboard Cite

SummaryBackground: Diagnosis of coronary artery disease (CAD) in women remains elusive. The classical diagnostic armamentarium has been found to be very limited. Dobutamine stress echocardiography has emerged as a powerful test in assessing CAD in the general population, but most studies failed to include women.Hypothesis: The accuracy of dobutamine stress echocardiography in the diagnosis of CAD in women with chest pain is high and superior to dipyridamole echocardiography, exercise electrocardiography, and sestamibi single-photon emission tomography (MIBI-SPECT) scintigraphy.Methods: We studied 99 consecutive women with chest pain and no previous history of CAD who underwent dobutamine echocardiography and coronary angiography. We also compared these results with those of dipyridamole echocardiography in 63 patients, exercise stress testing in 83 (48 conclusive), and MIBI-SPECT scintigraphy during dobutamine infusion in 54.Results: Significant CAD was found in 42 women. Sensitivity and specificity of dobutamine stress echocardiography were 69 and 89%, respectively. Dipyridamole echocardiogra-

show abstract

Assessment of coronary artery disease in women by dobutamine stress echocardiography: Comparison with stress thallium-201 single-photon emission computed tomography and exercise electrocardiography

Cited by 56 publications

References 27 publications

Role of Noninvasive Testing in the Clinical Evaluation of Women With Suspected Coronary Artery Disease

Role of Noninvasive Testing in the Clinical Evaluation of Women With Suspected Coronary Artery Disease

Noninvasive evaluation of ischaemic heart disease: myocardial perfusion imaging or stress echocardiography?

Dobutamine stress echocardiography in the diagnosis of coronary artery disease in women with chest pain: Comparison with different noninvasive tests

Contact Info

Product

Resources

About