Investigating the accuracy level of tests of history taking, exercise and myocardial scan with drug or with exercise in diagnosing women's anatomic lesion of coronary arteries

ABSTRACT

Coronary artery disease [CAD] is the most common cause of death in the world. Finding an accurate way to detect the CAD in early stages is important. In this study, our aim was to assess the rates of accuracy, sensitivity and specificity of history taking, exercise test and myocardial scan with drug or exercise, in the diagnosis of CAD in the patients who undergo angiography. In a cross-sectional study, 420 female patients who referred to Razavi and Javad-AL-Aeme Hospitals for angiography during 2007 to 2008, were studied. Having done the angiography, we came to determine which method [history, exercise test or scan] was the most appropriate for preparing the patient for angiography. To do so, their rates of accuracy, sensitivity and specificity were calculated. Sixty five percent of the subjects were suffering from CAD. The mean age of the patients was 58 years. Hypertension, hyperlipidemia, diabetes and smoking were detected in 39%, 42%, 24% and 5% of the cases, respectively. The rates of accuracy, sensitivity and specificity were respectively calculated as 3%, 78. 1%, 47.2% for history taking; 57.1%, 80%, 26.1% for exercise test and 73.1%, 90.9%, 15.3% for myocardial scan with drug. According to the results of this study and with regard to the relatively high cost of perfusion scan and exercise test, it seems that history taking has a high rate of accuracy in predicting and diagnosing CAD. Exercise test, in comparison with myocardial scan, has lower rates of accuracy, sensitivity and specificity in women