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:

Related Content

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
Videos | CT Angiography (CTA) | July 18, 2017
Matthew Budoff, M.D., FACC, professor of medicine, David Geffen School of Medicine at UCLA, endowed chair of preventi
FFR-CT, heartflow

An example of an FFR-CT image, showing the FFR values for all coronary vessel segments and the reduction in hemodynamic flow after specific lesions.

News | CT Angiography (CTA) | July 12, 2017
July 12, 2017 — The American Medical Association (AMA) has granted a Category III Tracking Code for estimated coronar
Videos | CT Angiography (CTA) | July 10, 2017
David Bluemke, M.D., Ph.D., FAHA, professor of radiology, University of Wisconsin - Madison, incoming editor of RSNA’
Heartflow FFR-CT can noninvasively assess the hemodynamic impact of coronary lesions to avoid the need for an invasive angiogram.

HeartFlow FFR-CT can noninvasively assess the hemodynamic impact of coronary lesions to avoid the need for an invasive angiogram.

Technology | CT Angiography (CTA) | July 06, 2017
July 6, 2017 — GE Healthcare and HeartFlow Inc.
cardiac CT showing a severe right coronary artery lesion on a Toshiba Aquillion One

A cardiac CT showing a severe right coronary artery lesion on both 3-D and curved multiplanar reconstructions from a Toshiba Aquilion One CT system. The newest generation of CT scanners have very fast gantry speeds to freeze cardiac motion, improved image quality and much lower doses than previous generation scanners from a decade ago.

Feature | CT Angiography (CTA) | April 13, 2017 | Dave Fornell
Cardiac computed tomography (CT) imaging really took off a decade ago with the introduction of 64-slice scanners, whi
CTA, CT angiography, predict heart attacks, Radiology study
News | CT Angiography (CTA) | March 14, 2017
Noninvasive computed tomography (CT) angiography and stress tests can help predict which patients are likely to suffer...
HeartFlow FFRct Analysis, NICE guidance, U.K., United Kingdom, guidelines, stable chest pain
News | CT Angiography (CTA) | February 14, 2017
The National Institute for Health and Care Excellence (NICE) in the United Kingdom recently issued guidance for use of...
Overlay Init