Aim: The aim of present study was to analyze the prevalence and pattern of coronary artery disease (CAD) among women who underwent coronary angiography (CAG) and Treadmill Test (TMT). Methods: A total of 100 consecutive women patients for coronary angiogram were studied at Department of Cardiology, Government Medical College, Kottayam, Kerala, India on over a period of 6 months from February 2008. Total 65 women completed TMT stress test. The patients were subjected to CAG and TMT. Data were analyzed by using SPSS 20.0 software. Results: A total of 100 women patients were included. Among that 66% patients had hypertension and 47% patients had diabetes mellitus. The CAG revealed the presence of 17%, 13% and 15% of single vessel disease, double vessel disease, and triple vessel disease respectively. Vessel involvements were notably higher in positive TMT values during stress test. The sensitivity and specificity of TMT for detecting coronary artery disease in women were 61% and 69% respectively. Conclusion: It is concluded that, the findings of the present study effectively demonstrated higher predictive value of TMT in women with chest pain suggestive of CAD.
References
[1]
Celermajer, D.S., Chow, C.K., Marijon, E., Anstey, N.M. and Woo, K.S. (2012) Cardiovas-cular Disease in the Developing World: Prevalences, Patterns, and the Potential of Early Disease Detection. Journal of the American College of Cardiology, 60, 1207-1216. https://doi.org/10.1016/j.jacc.2012.03.074
[2]
Bruce, R.A., DeRouen, T.A., Hossack, K.F., Blake, B. and Rn Hofer, V. (1980) Value of Maximal Exercise Tests in Risk Assessment of Primary Coronary Heart Disease Events in Healthy Men. The American Journal of Cardiology, 46, 371-378.
https://doi.org/10.1016/0002-9149(80)90003-X
[3]
Froelicher Jr., V.F., Yanowitz, F.G., Thompson, A.J. and Lancaster, M.C. (1973) The Cor-relation of Coronary Angiography and the Electrocardiographic Response to Maximal Treadmill Testing in 76 Asymptomatic Men. Circulation, 48, 597-604.
https://doi.org/10.1161/01.CIR.48.3.597
[4]
Junker, J., Meyer, A., Flake, D. and Montgomery, L. (2004) Clinical Inquiries. Is Exercise Treadmill Testing Useful for Detecting Heart Disease in Women? The Journal of Family Practice, 53, 321-324.
[5]
Welch, C.C., Proudfit, W.L. and Sheldon, W.C. (1975) Coronary Arteriographic Findings in 1,000 Women under Age 50. The American Journal of Cardiology, 35, 211-215. https://doi.org/10.1016/0002-9149(75)90003-X
[6]
DeCara, J.M. (2003) Noninvasive Cardiac Testing in Women. Journal of the American Medical Women's Association, 58, 254-263.
[7]
Metz, L.D., Beattie, M., Hom, R., Redberg, R.F., Grady, D. and Fleischmann, K.E. (2007) The Prognostic Value of Normal Exercise Myocardial Perfusion Imaging and Exercise Echocardiography: A Meta-Analysis. Journal of the American College of Cardiology, 49, 227-237. https://doi.org/10.1016/j.jacc.2006.08.048
[8]
Navare, S.M., Mather, J.F., Shaw, L.J., Fowler, M.S. and Heller, G.V. (2004) Comparison of Risk Stratification with Pharmacologic and Exercise Stress Myocardial Perfusion Im-aging: A Meta-Analysis. Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology, 11, 551-561.
https://doi.org/10.1016/j.nuclcard.2004.06.128
[9]
Peteiro, J., Monserrrat, L., Pineiro, M., Calvino, R., Vazquez, J.M., Marinas, J. and Cas-tro-Beiras, A. (2006) Comparison of Exercise Echocardiography and the Duke Treadmill Score for Risk Stratification in Patients with Known or Suspected Coronary Artery Disease and Normal Resting Electrocardiogram. American Heart Journal, 151, 1324.e1321-1310. https://doi.org/10.1016/j.ahj.2006.03.015
[10]
Bangalore, S., Gopinath, D., Yao, S.S. and Chaudhry, F.A. (2007) Risk Stratification Using Stress Echocardiography: Incremental Prognostic Value over Historic, Clinical, and Stress Electrocardiographic Variables across a Wide Spectrum of Bayesian Pretest Probabilities for Coronary Artery Disease. Journal of the American Society of Echocar-diography: Official Publication of the American Society of Echocardiography, 20, 244-252. https://doi.org/10.1016/j.echo.2006.08.014
[11]
Gianrossi, R., Detrano, R., Mulvihill, D., Lehmann, K., Dubach, P., Colombo, A., McArthur, D. and Froelicher, V. (1989) Exercise-Induced ST Depression in the Diagnosis of Cor-onary Artery Disease. A Meta-Analysis. Circulation, 80, 87-98.
https://doi.org/10.1161/01.CIR.80.1.87
[12]
Fleischmann, K.E., Hunink, M.G., Kuntz, K.M. and Douglas, P.S. (1998) Exercise Echo-cardiography or Exercise SPECT Imaging? A Meta-Analysis of Diagnostic Test Perfor-mance. The Journal of the American Medical Association, 280, 913-920.
https://doi.org/10.1001/jama.280.10.913
[13]
Geleijnse, M.L., Krenning, B.J., van Dalen, B.M., Nemes, A., Soliman, O.I., Bosch, J.G., Galema, T.W., Ten Cate, F.J. and Boersma, E. (2009) Factors Affecting Sensitivity and Specificity of Diagnostic Testing: Dobutamine Stress Echocardiography. Journal of the American Society of Echocardiography: Official Publication of the American Society of Echocardiography, 22, 1199-1208.
https://doi.org/10.1016/j.echo.2009.07.006
[14]
Janand-Delenne, B., Savin, B., Habib, G., Bory, M., Vague, P. and Lassmann-Vague, V. (1999) Silent Myocardial Ischemia in Patients with Diabetes: Who to Screen. Diabetes Care, 22, 1396-1400. https://doi.org/10.2337/diacare.22.9.1396
[15]
Yoo, W.S., Kim, H.J., Kim, D., Lee, M.Y. and Chung, H.K. (2009) Early Detection of Asymptomatic Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus. The Korean Journal of Internal Medicine, 24, 183-189.
https://doi.org/10.3904/kjim.2009.24.3.183
[16]
Bax, J.J., Young, L.H., Frye, R.L., Bonow, R.O., Steinberg, H.O. and Barrett, E.J. (2007) Screening for Coronary Artery Disease in Patients with Diabetes. Diabetes Care, 30, 2729-2736. https://doi.org/10.2337/dc07-9927