Noninvasive Technologies for Diagnosing Coronary Artery Disease in Women
Background: Using Noninvasive Technologies To Diagnose Coronary Artery Disease (1 of 2)
For patients at intermediate risk for coronary artery disease (CAD) and for patients for whom coronary angiography is contraindicated (patients who are unable to tolerate invasive catheterization or whose vascular disease increases their risk of procedure-related bleeding or blockage), noninvasive technologies (NITs) are an important diagnostic option.
The American Heart Association (AHA) and the American College of Cardiology recommend that women with suspected CAD should be classified as either symptomatic or asymptomatic and further classified as being at low, intermediate, or high risk for the disease to guide the decision about which diagnostic test to use first.
In 2005, the AHA developed a consensus statement on the role of noninvasive testing in the clinical evaluation of women with suspected CAD. In this statement, the AHA recommended that women who are asymptomatic and have low (<10%) pretest probability of having CAD should not undergo cardiac imaging studies; for women who have low (<10%) to intermediate (10% to 90%) pretest probability of CAD (such as women with atypical chest pain who might need reassurance that their symptoms are not cardiac in origin), NITs with high negative predictive value and low risk of adverse events are suggested; for women who are symptomatic and have intermediate (10% to 90%) pretest probability of CAD, NITs that provide the right balance of sensitivity, specificity, and clinical risk are recommended.
Keywords: background | coronary artery disease | CAD | women | diagnosis | noninvasive technologies | symptomatic | asymptomatic
- Dolor RJ, Patel MR, Melloni C, et al. Noninvasive Technologies for the Diagnosis of Coronary Artery Disease in Women. Comparative Effectiveness Review No. 58 (Prepared by the Duke Evidence-based Practice Center under Contract No. 290-2007-10061-I). Rockville, MD: Agency for Healthcare Research and Quality; June 2012. AHRQ Publication No. 12-EHC034-EF. Available at www.effectivehealthcare.ahrq.gov/diagnosecad.cfm.
- Mieres JH, Shaw LJ, Arai A, et al. Role of noninvasive testing in the clinical evaluation of women with suspected coronary artery disease: consensus statement from the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association. Circulation 2005;111(5):682-96. PMID: 15687114.
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