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Noninvasive Technologies for Diagnosing Coronary Artery Disease in Women

Slide: 14 of 23

Accuracy of NITs in Diagnosing CAD in Symptomatic Women Without a Known Diagnosis of CAD (1 of 2)

The accuracy of the various noninvasive technologies (NITs) used to diagnose coronary artery disease (CAD) in symptomatic women with no known CAD was assessed. The findings are as follows:

Accuracy of exercise/stress electrocardiography (ECG):

Twenty-eight studies reported on ECG use in a total of 3,328 women with no known coronary artery disease (CAD). In these studies, sensitivity varied from 32 to 91 percent, and specificity varied from 40 to 100 percent; the median sensitivity was 62 percent, and the median specificity was 68 percent. In the 10 good-quality studies in women with no known CAD, sensitivity varied from 32 to 91 percent, and specificity varied from 46 to 81 percent; the median sensitivity was 71 percent, and the median specificity was 58 percent. The strength of evidence for ECG as a diagnostic tool was high.

Accuracy of exercise/stress echocardiography (ECHO):

Fourteen studies reported on ECHO use in 1,289 women with no known CAD. In these studies, sensitivity varied from 57 to 90 percent, and specificity varied from 37 to 96 percent; the median sensitivity was 79 percent, and the median specificity was 82 percent. In the 5 good-quality studies, sensitivity varied from 68 to 87 percent, and specificity varied from 71 to 96 percent; the median sensitivity was 80 percent, and the median specificity was 82 percent. The strength of evidence for exercise/stress ECHO as a diagnostic tool was high.

Accuracy of exercise/stress radionuclide myocardial perfusion imaging with single photon positron emission tomography (SPECT):

Thirteen studies reported on SPECT use in 937 women with no known CAD. In these studies, sensitivity varied from 62 to 93 percent, and specificity varied from 50 to 91 percent; the median sensitivity was 82 percent, and the median specificity was 80 percent. In the 4 good-quality studies in women with no known CAD, sensitivity varied from 62 to 93 percent, and specificity varied from 50 to 91 percent; the median sensitivity was 83 percent, and the median specificity was 68 percent. The overall strength of evidence for SPECT as a diagnostic tool was high.