Routine Noninvasive Testing for CAD Minimally Beneficial
Researchers found only a low yield among patients presenting with acute chest pain and low clinical risk.
(HealthDay News) -- For patients presenting with acute chest pain and low clinical risk evaluated in a chest pain evaluation center (CPEC), the yield of routine noninvasive testing is low for coronary artery disease (CAD), according to a study published in The American Journal of Cardiology.
David E. Winchester, M.D., from the University of Florida in Gainesville, and colleagues analyzed data from a prospective cohort of patients who underwent evaluation at a CPEC. 213 patients who presented with normal initial electrocardiogram and cardiac injury markers underwent observation and noninvasive CAD testing at a CPEC.
The patients were young (mean age, 43.8 years), obese (mean body mass index, 30.8 kg/m²), and mainly women (64.8%). The researchers found that 11 of the 203 patients who underwent testing had abnormal results, of whom 4 had obstructive CAD based on invasive coronary angiography. The positive predictive value for obstructive CAD was 45.5% after an abnormal test. The overall diagnostic yield for obstructive CAD was 2.5%.
"In conclusion, in patients with acute chest pain evaluated in a CPEC, the yield of routine use of noninvasive testing for CAD was minimal and the positive predictive value of an abnormal test was low," the authors write.