[Differences between women and men in the dipyridamole test. Symptomatic and electrocardiography findings in patients with coronary heart disease].

BACKGROUND

Problems are often encountered in evaluating the exercise stress ECG in women due to frequent false pathological findings. Besides the exercise ECG in the noninvasive diagnosis of coronary heart disease (CHD), the dipyridamole test is often used. As yet little is known about, whether a similarly high incidence of false positive test results occur under provocation with dipyridamole in women as in the exercise stress ECG.

PATIENTS

In the present study the results of the dipyridamole test and of the coronary angiography in 218 patients, diagnosed as suspected of having CHD, were compared, especially allowing for specific sex differences.

RESULTS

The prevalence of CHD in women was 17.8% and 56.1% in men. Under provocation with dipyridamole allowing for the indicator angina pectoris, the incidence of a false positive test results in relation to a significant coronary stenosis is higher in women with 80.5% than in men with 36.4% (p < 0.001). By contrast, men have a significantly higher rate of false negative test findings (40.9% to 11.1%; p < 0.001). Whereas the women obtained a sensitivity of 87.5%, the rating for men was 70.1%. Specificity was 21.6% for women and 48.7% for men. Test efficiency for men was 60.7% whereas for women 33.3% were calculated. The reaction of heart rate (significant increase of 33%) and systolic and diastolic blood pressure (no significant changes) did not reveal any relevant differences between men and women during the dipyridamole test.

CONCLUSION

For patients with CHD similar diagnostic uncertainties occurred relating to specific sex differences in the results of the dipyridamole test, just like those known from the exercise ECG.