News | Cardiac Diagnostics | April 06, 2016

Diagnostic Tests for Heart Disease Function Differently for Women, Men

Duke study finds CT angiography more predictive of future coronary events for women, equal to stress test for men

Duke Clinical Research Institute study, DCRI, women and men, heart disease, diagnostic tests, stress, CT angiography, ACC 2016

April 6, 2016 — Tests used to diagnose and assess the severity of coronary artery disease appear to function differently for women and men who have stable symptoms, according to researchers from Duke Clinical Research Institute.

The finding, presented April 4 at the American College of Cardiology (ACC) Scientific Sessions meeting in Chicago, adds new insights into the differences between men and women who are newly diagnosed with heart disease.

Analyzing data from the PROMISE study (Prospective Multicenter Imaging Study for Evaluation of Chest Pain), researchers previously found that for both women and men, heart attacks and other events occurred at the same rate regardless of whether patients were assessed using a computed tomography (CT) angiography or a functional stress test.

However, since the frequency of a positive test differed between the two test types, the ability to predict an event based on test findings was not the same for CTA versus stress testing.

More women had a positive stress test than a CTA, but given the same event rate, this meant that a smaller proportion who had a positive stress test went on to have a coronary event — death, heart attack or other heart problem leading to hospitalization. As a result, CTA proved to be more predictive than a stress test of a future coronary event among women.

For men, a stress test showed a positive finding for heart disease less often than CTA, but the predictive value of CTA and the stress testing for an event was roughly similar.

“In the main PROMISE study analysis, the rates of coronary events were similar whether patients were tested with CTA or a stress test,” said lead author Neha Pagidipati, M.D., of DCRI. “Our analysis delved a little deeper to determine if there were subtle differences between the sexes associated with using these diagnostic tests.”

Pagidipati said the differences in women are statistically significant and could help guide test selection and the interpretation of test results, but do not yet provide a basis to recommend that all women undergo CTA instead of functional stress tests. Instead, she said, the findings point strongly to the need for a study specifically designed to answer that question.

In addition to Pagidipati, study authors include Kshipra Hemal, Adrian Coles, Daniel B. Mark, Rowena J. Dolor, Patricia A. Pellikka, Udo Hoffmann, Sheldon E. Litwin, James Udelson, Melissa A. Daubert, Svati H. Shah, Beth Martinez, Kerry L. Lee, and Pamela S. Douglas.

This project received support from the National Heart, Lung, and Blood Institute (R01HL098237, R01HL098236, R01HL98305 and R01HL098235).

For more information: www.acc.org

Related Content

A comparison of CT image of heavily calcified coronary arteries that appear to present a significant hemodynamic blockages and the correspending FFR-CT showing the patient had adequate blood flow and does not need a diagnostic angiogram or intervention.

A comparison of a CT image of heavily calcified coronary arteries that appear to present a significant hemodynamic blockage and the corresponding FFR-CT showing the patient had adequate blood flow and does not need a diagnostic angiogram or intervention. Image courtesy of Kavitha Chinnaiyan, William Beaumont Hospital.

Feature | CT Angiography (CTA) | July 23, 2018 | Dave Fornell, Editor
The use of non-invasive fractional flow reserve CT (FFR-CT) was the hottest topic discussed at the Society of Cardiov
Videos | CT Angiography (CTA) | July 19, 2018
Kavitha Chinnaiyan, M.D., FACC, FSCCT, associate professor, Oakland University, William Beaumont School of Medicine,
Videos | CT Angiography (CTA) | July 18, 2018
A discussion with Gianluca Pontone, M.D., Ph.D., FSCCT, director of cardiovascular MRI, Centro Cardiologico Manzino,
Videos | CT Angiography (CTA) | July 17, 2018
A discussion with Todd Villines, M.D., FACC, FAHA, FSCCT, cardiologist, Georgetown Medical Center, and president of t
HeartFlow Announces New Commercial Coverage With UnitedHealthcare
News | CT Angiography (CTA) | July 03, 2018
HeartFlow Inc. announced that UnitedHealthcare now covers the HeartFlow FFRct Analysis, extending access to their 45...
Post-Mortem CT Angiography Illuminates Causes of Death
News | CT Angiography (CTA) | June 25, 2018
Computed tomography (CT) angiography is a useful adjunct to autopsy that is likely to increase the quality of post-...
iSchemaView Receives FDA Clearance for Rapid CTA
Technology | CT Angiography (CTA) | May 01, 2018
Cerebrovascular imaging analysis company iSchemaView received final clearance from the U.S. Food and Drug...
The use of metal artifact reduction software on this CCTA (CTA) cardiac CT from an Canon, Toshiba, Aquilion Precision, allows clear visualization inside a coronary stent. The 0.25 mm high-resolution reconstruction also helps delineate the various components of plaque.

The use of metal artifact reduction software on this Aquilion Precision image allows clear visualization inside a coronary stent. The 0.25 mm high-resolution reconstruction also helps delineate the various components of plaque.

Feature | CT Angiography (CTA) | April 26, 2018 | Dave Fornell
There have been a few big, recent advancements in cardiac computed tomography angiography (CCTA) imaging technology.
Siemens Healthineers, Florida Hospital Collaborate to Improve Healthcare Outcomes
News | CT Angiography (CTA) | January 23, 2018
January 23, 2018 – Siemens Healthineers and Florida Hospital, part of Adventist Health System, have announced a multi
Videos | CT Angiography (CTA) | July 21, 2017
DAIC and ITN Editor Dave Fornell discusses some of the most innovative new computed tomography (CT) technology and tr
Overlay Init