[The influence of sex on the performance of dobutamine echocardiography for the diagnosis of ischemic cardiopathy].

OBJECTIVE

To compare the usefulness of dobutamine-atropine stress echocardiography in the diagnosis of coronary artery disease among men and women.

METHODS

We have consecutively studied 137 men and 99 women without a previous history of coronary artery disease who underwent dobutamine-atropine stress echocardiography and coronary angiography afterwards.

RESULTS

Significant coronary artery disease was detected in 102 men and 42 women (74% and 42% respectively; p < 0.001). 64% of the women had single-vessel versus 45% of the men (p < 0.05). Dobutamine-atropine stress echocardiography was positive in 78 men and 35 women. Sensitivity, specificity and diagnostic accuracy of the test were 72%, 88% and 76% for men and 69%, 89% and 83% for women (p = NS). Positive predictive value was higher in men (95% in men versus 83% in women; p < 0.05) and negative predictive value was significantly greater in women than in men (79% versus 52%; p < 0.01).

CONCLUSION

Sensitivity, specificity and diagnostic accuracy of dobutamine-atropine stress echocardiography is not affected by gender. Positive predictive value is higher in men and negative in women owing to the differences in both sexes of the prevalence of coronary artery disease.