Sketch M H, Mohiuddin S M, Lynch J D, Zencka A E, Runco V
Am J Cardiol. 1975 Aug;36(2):169-73. doi: 10.1016/0002-9149(75)90521-4.
Two hundred fifty-one patients (195 male and 56 females) referred for evaluation of chest pain were studied by multistage submaximal stress testing and selective coronary arteriography. In men with positive exercise tests the incidence rate of true positive exercise test results--that is, positive tests associated with 75 percent of greater coronary stenosis--was 89 percent in contrast to a 33 percent incidence rate of true positive exercise test results in women. The incidence rate of false positive excercise test results--that is, positive tests associated with no coronary stenosis or less than 50 percent stenosis--was 8 percent in men in contrast to 67 percent in women. Conversely, the incidence rate of false negative exercise test results (that is, negative exercise tests associated with 75 percent or greater coronary stenosis) was higher in men (37 percent) than in women (12 percent). It is concluded that in men a positive multistage stress test is useful in predicting the presence of significant coronary artery disease although a negative stress test cannot be relied upon to rule out the presence of significant disease. In women, a positive exercise test is of little value in predicting the presence of significant coronary artery disease, whereas a negative test is quite useful in ruling out the presence of significant disease. New criteria should be developed for stress testing of women.
对251例因胸痛前来评估的患者（195例男性和56例女性）进行了多级次极量运动试验和选择性冠状动脉造影研究。在运动试验阳性的男性中，运动试验真阳性结果的发生率——即与75%及以上冠状动脉狭窄相关的阳性试验——为89%，而女性运动试验真阳性结果的发生率为33%。运动试验假阳性结果的发生率——即与无冠状动脉狭窄或狭窄小于50%相关的阳性试验——男性为8%，女性为67%。相反，运动试验假阴性结果（即与75%及以上冠状动脉狭窄相关的阴性运动试验）的发生率男性（37%）高于女性（12%）。结论是，在男性中，多级次运动试验阳性有助于预测显著冠状动脉疾病的存在，尽管不能依靠阴性运动试验排除显著疾病的存在。在女性中，运动试验阳性对预测显著冠状动脉疾病的存在价值不大，而阴性试验在排除显著疾病的存在方面非常有用。应为女性的运动试验制定新的标准。
