Computed Tomography Angiography Approach in Low-Intermediate Test Probability with Positive Exercise Electrocardiography Test in Young Women
Ahmet Çağrı Aykan, Ezgi Kalaycıoğlu, Tayyar Gökdeni̇z, Duygun Altıntaş Aykan, İsmail Gökhan Çavuşoglu, Abdulkadir Uslu, Ahmet Oğuz Aslan, Ömer Faruk Çırakoğlu, Banu Şahi̇n Yıldız, Şükrü Çeli̇k
Keywords: Exercise electrocardiography, computed tomography, angiography, pretest probability, women, young
Introduction: Stress imaging tests are recommended in patients with positive exercise electrocardiography (EECG) and intermediate pretest probability. However the role of coronary computed tomography angiography (CCTA) in young women with intermediate pretest probability and positive EECG is under debate. The aim of this study was to assess the diagnostic value of CCTA in young women patients with low-intermediate pretest probability and positive EECG results. Patients and Methods: From a retrospective registry of 67 young women with positive EECG between January 2011 and January 2014 were included in this study. Of these 67 patients 32 patients underwent CCTA and 35 patients underwent MPS after EECG. Results: There were no statistically significant differences between groups in demographic variables, or cardiovascular risk profile. The exercise test was positive in all patients. Both groups were similar for exercise capacity and Duke treadmill score. Blood chemistry of the patients were similar. The median pre-test probability of obstructive coronary artery disease (CAD) was lower in CCTA group 28% (15-45%) than in MPS group (15-50) (p= 0.045). Overall 3 patients in the CCTA and 7 patients in the MPS group had significant lesions. All patients in the CCTA positive group had significant CAD, while 3 out of 7 patients with positive MPS findings had significant CAD in coronary angiography. Conclusion: CCTA may be a valuable alternative of stress imaging tests in women patients with low-intermediate pretest probability and positive EECG.