title: [A non-invasive test choice for the diagnosis of coronary disease in women].
abstract: OBJECTIVE
  Regarding coronary heart disease, women have often been excluded from clinical trials. Current practical recommendations are thus based on studies in men. To identify the non invasive technique of choice in detecting coronary artery disease in women, a study with different diagnostic tests has been undertaken.
  
  
  METHODS
  Exercise stress test, dipyridamole echocardiography (0.84 mg/kg), dobutamine echocardiography (up to a total dose of 40 micrograms/kg per minute and atropine if necessary), MIBI-SPECT during dobutamine infusion and coronary angiography, were performed in 40 consecutive women with chest pain and no previous history of coronary artery disease.
  
  
  RESULTS
  The four tests had similar sensitivity: exercise stress test (80%; CI 95%, 52-94), dipyridamole echocardiography (80%; CI 95%, 56-93), dobutamine echocardiography (80%; CI 95%, 56-93) and scintigraphy MIBI-SPECT (85%; CI 95%, 61-95). The specificity of dipyridamole echocardiography (100%; CI 95%, 83-100) and dobutamine echocardiography (90%; CI 95%, 67-98) was higher than that of exercise stress test (50%; CI 95%, 22-78) and MIBI-SPECT (65%; CI 95%, 41-84). The positive predictive values of dipyridamole and dobutamine echocardiography were 100% and 88% respectively.
  
  
  CONCLUSIONS
  The feasibility of exercise stress test in women is inferior to that of the other techniques. The sensitivity of the four tests to diagnose coronary artery disease is similar. The specificity of dipyridamole echocardiography and dobutamine echocardiography is higher than that of exercise stress test and MIBI-SPECT. Stress echocardiography can be considered the non invasive technique of choice for diagnosing coronary artery disease in women.
authors.affiliation: Servicio de Cardiología, Hospital Universitario San Carlos, Madrid.
authors.forename: V
authors.initials: V
authors.lastname: Peral Disdier
authors.forename: I
authors.initials: I
authors.lastname: Vilacosta
authors.forename: J A
authors.initials: JA
authors.lastname: San Román
authors.forename: J A
authors.initials: JA
authors.lastname: Castillo
authors.forename: E
authors.initials: E
authors.lastname: Batlle
authors.forename: M
authors.initials: M
authors.lastname: Hernández
authors.forename: E
authors.initials: E
authors.lastname: Meroño
authors.forename: C
authors.initials: C
authors.lastname: Graupner
authors.forename: M J
authors.initials: MJ
authors.lastname: Rollán
authors.forename: R
authors.initials: R
authors.lastname: Morales
authors.forename: L
authors.initials: L
authors.lastname: Alonso
authors.forename: L
authors.initials: L
authors.lastname: Sánchez-Harguíndey
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis*; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon