Diagnostic performance of 64-slice multidetector coronary computed tomographic angiography in women.
BACKGROUND
Diagnostic approach to chest pain in women is challenging, but still under-investigated. The purpose of this study was to assess the diagnostic performance of 64-slice multidetector coronary computed tomographic angiography (CCTA) in women with chest pain.


RESULTS
We included 606 patients--255 women and 351 men (mean age 61 ± 12 years for both)--who had been referred for a CCTA and an invasive coronary angiography (diagnostic standard) because of chest pain, either as part of clinical work-up in two urban medical centers or as part of the multicenter ACCURACY trial. On a patient-based model, the sensitivity, specificity, and positive predictive value (PPV) and negative predictive value to detect ≥50% and ≥70% stenosis were 98%, 84%, 87%, and 97% and 96%, 83%, 77%, and 97%, respectively, for women and 97%, 83%, 89%, and 95% and 94%, 91%, 90%, and 94%, respectively, for men. There were no statistically significant differences between men and women in diagnostic performance measures except for the PPV of detecting a ≥70% stenosis (P = .007).


CONCLUSIONS
In women with chest pain, 64-slice multidetector CCTA is at least as sensitive and specific as in men. Our findings suggest that CCTA is a promising diagnostic tool for timely detection and/or exclusion of CAD in symptomatic intermediate-risk female populations.
Division of Cardiology, Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, 1124 W Carson St, Torrance, CA 90502, USA.
Borut
B
Jug
Mohit
M
Gupta
Jenny
J
Papazian
Dong
D
Li
Janet
J
Tsang
Harpreet
H
Bhatia
Ronald
R
Karlsberg
Matthew
M
Budoff
D000368:Aged; D002637:Chest Pain / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D012107:Research Design; D012680:Sensitivity and Specificity