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What is the diagnostic value of history and maximal exercise electrocardiography compared to coronary arteriography in men and women suspected of coronary heart disease?
What is the diagnostic value of history and maximal exercise electrocardiography compared to coronary arteriography in men and women suspected of coronary heart disease?
Differences in the predictive value of exercise ECG between men and women are primarily driven by differing baseline prevalences of coronary heart disease rather than differences in test sensitivity or specificity.
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Sex differences in ECG accuracy reflect CHD prevalence; leaves open whether prevalence-adjusted interpretation improves diagnosis in suspected CHD.
Coronary arteriographic data have been compared in 278 patients (231 males and 47 females) with the ECG response to a maximal exercise test and with the history (myocardial infarction - MI, typical or atypical angina pectoris -AP). The sensitivity and specificity of exercise ECG were similar in males and females. False negative ECG responses were frequent in males (40%) and false positive ECG responses were frequent in females (38%). This difference between sexes was essentially due in our patients to the higher prevalence of CHD in males (80%) than in females (43%).
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Detry et al. (1977) studied this question.
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