Exercise stress testing had a higher false-positive rate in women than men (53% vs 12%, P<0.001), but this difference was not seen when matched for coronary artery disease prevalence.
Observational (n=2,045)
Yes
Does the diagnostic accuracy of exercise stress testing for predicting coronary-artery disease depend on the pre-test prevalence of the disease in men and women with chest pain?
The ability of exercise stress testing to predict coronary artery disease is limited and highly dependent on the pre-test probability of disease, which varies by sex and chest pain classification.
Absolute Event Rate: 12% vs 53%
p-value: p=<0.001
To determine to what extent the diagnostic accuracy of stress testing is influenced by the prevalence of coronary-artery disease, we correlated the description of chest pain, the result of stress testing and the results of coronary arteriography in 1465 men and 580 women from a multicentered clinical trial. The pre-test risk (prevalence of coronary-artery disease) varied from 7 to 87 per cent, depending on sex and classification of chest pain. A positive stress test increased the pre-test risk by only 6 to 20 per cent, whereas a negative test decreased the risk by only 2 to 28 per cent. Aothough the percentage of false-positive results differed between men and women (12 +/- 1 per cent versus 53 +/- 3 per cent P less than 0.001), this difference was not seen in a subgroup matched for prevalence of coronary-artery disease. We conclude that the ability of stress testing to predict coronary-artery disease is limited in a heterogeneous population in which the prevalence of disease can be estimated through classification of chest pain and the sex of the patient.
Weiner et al. (1979) conducted an observational in Coronary-artery disease (n=2,045). Exercise stress testing vs. Coronary arteriography was evaluated on False-positive results of stress testing (men vs women) (p=<0.001). Exercise stress testing had a higher false-positive rate in women than men (53% vs 12%, P<0.001), but this difference was not seen when matched for coronary artery disease prevalence.