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ACC: Prognostic Value of Cardiac Noninvasive Tests Vary by Sex

Women seem to derive more prognostic value from computed tomographic angiography

heart monitor

TUESDAY, April 5, 2016 (HealthDay News) -- For patients with suspected coronary artery disease, the prognostic value of cardiac noninvasive tests (NITs) varies by test type and sex, according to a study published online April 4 in the Journal of the American College of Cardiology. The research is being published to coincide with the annual meeting of the American College of Cardiology, held from April 2 to 4 in Chicago.

Neha J. Pagidipati, M.D., M.P.H., from the Duke University School of Medicine in Durham, N.C., and colleagues compared the results and prognostic information for PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) trial patients (4,500 randomized to computed tomographic angiography [CTA] and 4,466 to stress testing).

The researchers found that a positive CTA (≥70 percent stenosis) was less likely than a positive stress test in women (8 versus 12 percent; adjusted odds ratio [aOR], 0.67). A positive versus negative CTA correlated more strongly with subsequent clinical events than a positive stress test (CTA-adjusted hazard ratio [HR], 5.86; stress-adjusted HR, 2.27; adjusted P = 0.028). A positive CTA was more likely than a positive stress test in men (16 versus 14 percent; aOR, 1.23). In men, a positive versus negative CTA was less strongly associated with subsequent clinical events than a positive stress test (CTA-adjusted HR, 2.80; stress-adjusted HR, 4.42; adjusted P = 0.168).

"Women appear to derive more prognostic information from a CTA, while men tend to derive similar prognostic value from both test types," the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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