Effectiveness of cardiogoniometry compared with exercise-ECG test in diagnosing stable coronary artery disease in women.
OBJECTIVE
To investigate the effectiveness of cardiogoniometry, a novel, non-invasive method, in diagnosing coronary artery disease (CAD) in women and compare it with exercise-ECG test, by using coronary angiography as a reference method.


METHODS
It was a single-centre, case-series study including consecutive female patients with stable angina pectoris (AP) undergoing coronary angiography. Exercise-ECG test, done according to the Bruce protocol, and cardiogoniometry were obtained prior to coronary angiography. Clinically significant CAD has been defined as one or more coronary lesions with >70% stenosis.


RESULTS
Study included 114 consecutive female patients with median age of 64.0 (58.0-71.0) years, out of which 32 (28.1%) had CAD. Cardiogoniometry yielded a total accuracy of 74.6% with a sensitivity of 75.0% (95% CI 56.6-88.5) and specificity of 74.4% (95% CI 63.6-83.4). Exercise-ECG test yielded a total accuracy of 45.1% with a sensitivity of 68.1% (95% CI 42.7-83.6) and specificity 36.6% (95% CI 25.2-50.3). Cardiogoniometry showed higher accuracy than exercise-ECG test ( P < 0.001). Pathological cardiogoniometry was associated with almost nine times higher risk for CAD (OR 8.7, 95%CI 3.4-22.3, P < 0.001), which remained significant after adjustment for age, and hypokinesia.


CONCLUSIONS
Cardiogoniometry is a non-invasive, easy-to-use and free-of-risk method which showed high effectiveness in diagnosing stable CAD in women and superior to exercise-ECG test. Cardiogoniometry could be introduced as a part of the diagnostic algorithm of screening women for stable CAD and is suitable for use in the primary setting, especially in women unable to undergo stress-testing.
From the Department of Cardiology, Sisters of Charity University Hospital Centre, Vinogradska cesta 29, 10 000 Zagreb, Croatia.
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Zeljkovic
From the Department of Cardiology, Sisters of Charity University Hospital Centre, Vinogradska cesta 29, 10 000 Zagreb, Croatia.|School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia.
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Pintaric
From the Department of Cardiology, Sisters of Charity University Hospital Centre, Vinogradska cesta 29, 10 000 Zagreb, Croatia.|School of Medicine, University of Zagreb, Šalata 3, Zagreb, Croatia.
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Vrsalovic
Department of Internal Medicine, Sisters of Charity University Hospital Centre, Vinogradska cesta 29, 10 000 Zagreb, Croatia.
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Kruljac
D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D004562:Electrocardiography / Q000379:methods*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D016037:Single-Blind Method