Non-invasive assessment of the risk of coronary heart disease.
OBJECTIVE
Non-invasive evaluations for the presence of coronary heart disease (CHD) are being done with increasing frequency in clinical medicine and as part of the risk selection process for life insurance. The predictive value of testing depends on the pretest probability of disease and the sensitivity and specificity of the testing used. This paper reviews the accuracy of exercise treadmill testing (ETT), myocardial perfusion imaging, stress echocardiography and electron beam computed tomography (EBCT) in the assessment of CHD risk.


METHODS
Literature review using Medline.


CONCLUSIONS
Non-invasive testing is most useful in assessing persons with known or suspected coronary heart disease. Although a low pretest likelihood of disease limits the predictive value in young subjects and subjects with no known risk factors, a positive ETT or EBCT calcium score >160 may be viewed as a risk factor for CHD.
Richie
Rodney C
RC
Texas Life Insurance Company, USA.
D003327:Coronary Disease / Q000401:mortality* / Q000517:prevention & control*; D003952:Diagnostic Imaging / Q000379:methods*; D005080:Exercise Test; D006801:Humans; D007352:Insurance, Life; D008403:Mass Screening / Q000379:methods*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012680:Sensitivity and Specificity