MPS 09-09 DIAGNOSTIC ACCURACY OF TREADMILL EXERCISE TESTS AMONG CHINESE WOMEN WITH CORONARY ARTERY DISEASES: A SYSTEMATIC REVIEW AND META-ANALYSIS

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Abstract

Objective:

Treadmill exercise test (TET) is one of the most common noninvasive diagnosis approaches for ischemic heart diseases, but potential reduction of TET accuracy among Chinese women patients was ignored by most studies, especially perimenopause women. Hence, we aim to perform a systematic review and meta-analysis evaluating the TET diagnostic accuracy for Chinese women, compared with coronary angiography (CAG).

Design and Method:

PubMed (1990 to 2015), MEDLINE (1990 to 2015), EMBASE (1990 to 2015), CNKI (1990 to 2015) and WANFANG (1990 to 2015) were performed to identify studies assessing the diagnostic accuracy of TET, compared with CAG. Random effects modeling strategies were used to produce summary receiver operating characteristic (SROC) curves, including overall estimates for sensitivity and specificity.

Results:

19 studies involving 2,396 Chinese females were included in our systematic review. TET has moderate levels of sensitivity (0.80) and specificity (0.65) to detect coronary artery stenosis in female patients with suspected coronary artery diseases, generating 0.79 of the area under the curve (AUC), compared to coronary angiography. In subgroup analyses, the pooled sensitivity of postmenopause and premenopausal/ perimenopause groups are 0.83 and 0.80, respectively. However, postmenopause group has a higher pooled specificity: 0.68 (95% confidence interval, 0.59–0.75) versus 0.32 (95% confidence interval, 0.18–0.50) compared with premenopausal & perimenopause women, as well as a higher corresponding AUC (0.81 versus 0.56). (Figure)

Conclusions:

TET may be used as triage tests for women with suspected and subclinical CAD. The positive results of TET should be treated with caution because of its higher false-positive, especially for premennopasal or perimenopause women, and further confirmatory diagnosis is needed. However, patients with negative TET results could be preclude for further evaluation using coronary angiography, and avoid unnecessary risk and economic burden to patients.

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