Does a positive exercise electrocardiogram predict coronary events differently in men and women with atypical chest pain?
Exercise electrocardiography has a significantly poorer predictive value for hard coronary events in women compared to men presenting with atypical chest pain.
In 1,455 subjects (947 men and 508 women) who underwent a bicycle ergometer stress test for evaluation of atypical chest pain, the incidence of coronary events (definite myocardial infarction or sudden death) was assessed by the life table method. The follow-up period ranged from 3 to 7 years (mean 5.2 years). In men with positive exercise test (ischemic ST depression ≧ 1 mm), the 5-year incidence of coronary events was 18.3%, compared with 1.9% in negative responders. In women with positive response, the 5-year incidence of coronary events was 4.6%; in negative responders, it was 0.3%. The poor predictive value of ischemic ST responses to exercise in women is emphasized.
Manca et al. (Fri,) studied this question.
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