Electron beam tomography and angiography: sex differences.
BACKGROUND
We sought to study a large cohort of symptomatic women to determine the clinical use of electron beam tomography (EBT), with evaluation of the sensitivity and specificity of obstructive coronary disease and the differences between premenopausal and postmenopausal cohorts.


METHODS
Patients who underwent angiography for evaluation of coronary artery disease (CAD) and EBT within 3 months were enrolled. Receiver operating characteristic curves were used to establish relationships between EBT calcium scores and angiographic disease.


RESULTS
We studied 1120 symptomatic patients, 387 women and 733 men. We found no significant differences with respect to sensitivity for obstructive disease (96% in men and women). However, women had a significantly higher specificity (46% in men versus 57% in women; P =.01). The area under the curves for coronary calcium score predicting angiographic disease was 0.85 for all patients and 0.84 in women. Evaluation of scores on the basis of age revealed a 14.4-year lag between men and women. One hundred thirty-five women had negative EBT study results (score, zero; no calcium present), with 6 with single-vessel disease and 129 with normal coronaries or nonobstructive disease only (negative predictive value, 96%).


CONCLUSIONS
EBT may have a great value in evaluation of women with possible CAD. The high sensitivity and high negative predictive value may serve as the basis for a new diagnostic approach to filter symptomatic women with suspected CAD before coronary angiography.
Budoff
Matthew J
MJ
Division of Cardiology, Saint John's Cardiovascular Research Center, Harbor-UCLA Medical Center Research and Education Institute, Torrance, CA 90502, USA. mbudoff@rei.edu
Shokooh
Shalizeh
S
Shavelle
Robert M
RM
Kim
H Tina
HT
French
William J
WJ
D002114:Calcinosis / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D017698:Postmenopause; D017697:Premenopause; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012727:Sex Characteristics; D014057:Tomography, X-Ray Computed