title: Utility of Pretest Probability and Exercise Treadmill Test in Korean Women with Suspected Coronary Artery Disease.
abstract: Pretest probability (PTP) and an exercise treadmill test (ETT) are recommended for the initial evaluation of possible coronary artery disease (CAD), but the applicability of these tests in Korean women has not been evaluated.
  
  
  
  Korean women with PTP, ETT, and invasive coronary angiography results were enrolled. Across all PTP levels, PTP and ETT statistics were evaluated and independent CAD predictors obtained.
  
  
  
  Of the 335 patients (mean age 58.0 ± 10.2 years), 99 and 236 were in the low (LPTP) and intermediate PTP (IPTP) groups, respectively. The observed prevalence of CAD was significantly lower than the PTP. (7.1% vs. 9.1 ± 4.9% in LPTP, p < 0.001; 23.3% vs. 33.0 ± 15.1% in IPTP, p < 0.001) The ETT's sensitivity and positive predictive values (PPVs) appeared lower than previously reported (LPTP: 42.9% and 16.7%; IPTP: 61.8% and 37.0%), whereas the negative predictive values (NPVs) were higher (LPTP: 95.1%; IPTP: 85.4%). After multivariate adjustments, positive ETT (odds ratio 3.276, 95% confidence interval 1.643-6.532, p = 0.001) independently predicted the presence of CAD, but the PTP showed only marginal predictability (odds ratio 1.019, 95% confidence interval 0.998-1.041, p = 0.069).
  
  
  
  In Korean women, the observed prevalence of CAD was lower than the PTP, and PTP showed only marginal CAD predictability. Although a positive ETT independently predicted CAD, the ETT showed lower sensitivity and PPVs than previously reported. Despite the limited value of PTP and ETT, the high NPVs of ETT appear useful for saving patients from unnecessary further examinations.
authors.affiliation: 1 Cardiovascular Center, Korea University Ansan Hospital , Ansan, Korea.
authors.forename: Yong-Hyun
authors.initials: YH
authors.lastname: Kim
authors.affiliation: 2 Cardiovascular Center, Korea University Anam Hospital , Seoul, Korea.
authors.forename: Wan-Joo
authors.initials: WJ
authors.lastname: Shim
authors.affiliation: 3 Cardiovascular Center, Seoul National University Boramae Hospital , Seoul, Korea.
authors.forename: Myung-A
authors.initials: MA
authors.lastname: Kim
authors.affiliation: 4 Cardiovascular Center, Chuncheon Sacred Heart Hospital , Chuncheon, Korea.
authors.forename: Kyung-Soon
authors.initials: KS
authors.lastname: Hong
authors.affiliation: 5 Cardiovascular Center, Gachon University Gil Hospital , Incheon, Korea.
authors.forename: Mi-Seung
authors.initials: MS
authors.lastname: Shin
authors.affiliation: 2 Cardiovascular Center, Korea University Anam Hospital , Seoul, Korea.
authors.forename: Seong-Mi
authors.initials: SM
authors.lastname: Park
authors.affiliation: 6 Cardiovascular Center, Kosin University Gospel Hospital , Busan, Korea.
authors.forename: Kyoung Im
authors.initials: KI
authors.lastname: Cho
authors.affiliation: 2 Cardiovascular Center, Korea University Anam Hospital , Seoul, Korea.
authors.forename: Mina
authors.initials: M
authors.lastname: Kim
authors.affiliation: 5 Cardiovascular Center, Gachon University Gil Hospital , Incheon, Korea.
authors.forename: Sihun
authors.initials: S
authors.lastname: Kim
authors.affiliation: 3 Cardiovascular Center, Seoul National University Boramae Hospital , Seoul, Korea.
authors.forename: Hak-Lyoung
authors.initials: HL
authors.lastname: Kim
authors.affiliation: 7 Cardiovascular Center, Chonnam University Hospital , Gwangju, Korea.
authors.forename: Hyun-Ju
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: 8 Cardiovascular Center, Korea University Guro Hospital , Seoul, Korea.
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Na
authors.affiliation: 9 Cardiovascular Center, Kangdong Sacred Heart Hospital , Seoul, Korea.
authors.forename: Sung-Eun
authors.initials: SE
authors.lastname: Kim
mesh_terms: D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000208:ethnology; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D011336:Probability; D012372:ROC Curve; D056910:Republic of Korea / Q000453:epidemiology; D012680:Sensitivity and Specificity