Background: Noninvasive testing for suspected coronary artery disease is challenging. We prospectively investigated whether measurements of carotid intima-media thickness in the presence or absence of albuminuria in patients with stable chest pain syndromes can be used as a noninvasive test algorithm for prediction of significant coronary artery disease. Additionally, this algorithm was tested with regard to gender differences.
Methods: Consecutive patients (79 men and 72 women) with stable chest pain syndromes and suspected coronary artery disease admitted for coronary angiography were studied. Measurements of intima-media thickness were performed by ultrasound. Urinary albumin excretion was measured in a random urine specimen. A positive test for coronary artery disease was defined as an intima-media thickness >or=1 mm or albuminuria.
Results: Sensitivity, specificity and positive likelihood ratio for a combination of intima-media thickness values >or=1 mm or presence of albuminuria to predict coronary artery disease were, respectively, 0.5, 0.73 and 1.27 in men and 0.68, 0.79 and 3.32 in women. Sensitivity, specificity and positive likelihood ratio for exercise ECG were, respectively, 0.54, 0.48 and 1.08 in men and 0.47, 0.45 and 0.8 in women.
Conclusions: Intima-media thickness of the common carotid artery or presence of albuminuria are clinically valuable parameters in the noninvasive diagnostic work up of women with stable chest pain syndromes. Their value is limited in men.