AN EVALUATION OF CORONARY ARTERY DISEASE BY CORONARY ANGIOGRAPHY IN TMT POSITIVE FEMALE PATIENTS

Abstract

Bushra Khanam1, Rishu Bansal2, Aastha Bansal3

BACKGROUND
Coronary Artery Disease (CAD) is one of the leading causes of mortality and morbidity in the world. It is now equally prevalent in developed and developing nations. Treadmill Test (TMT) remains a cost effective, easily available and widely applicable approach for early diagnosis of CAD, but has a relatively low sensitivity and specificity. Identification of CAD in women can be a diagnostic challenge because of several factors including the lower prevalence of obstructive CAD in women younger than 65 years, more atypical manifestations of ischaemic symptoms and more frequent resting ST changes.
MATERIALS AND METHODS
This study was conducted on 50 TMT positive female patients at Internal Medicine Department of Index Medical College Hospital and Research Centre, Indore. Patients were categorised into low, intermediate and high pretest probable groups on the basis of pretest probability score system. These patients were subjected to coronary angiography and the prevalence of CAD was analysed by using descriptive statistical methods.
RESULTS
Out of 50 TMT positive female patients, 12 were having CAD on angiography (24%) indicating a low predictive value of TMT in females. The prevalence of CAD was 70% in high pretest probability group compared to 5% in low pretest probability group indicating high predictive value of TMT in high pretest probability group. Single vessel disease was the most common (58%) followed by triple vessel disease (25%) and double vessel disease (17%).
CONCLUSION
TMT has a low predictive value for detecting CAD in female patients except those with a high pretest probability score.

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