Ahisha AG

East Point Medical College Hospital, Bangalore, India

Abstract Title: Treadmill Test (TMT) has Very Poor Positive Predictive Value in Indian Women with Suspected Coronary Artery Disease

Biography:

Ms. Ahisha AG has completed her Bachelor’s degree in Cardiac Physiology from Vivekanandha Medical Care Hospital & Dr. MGR Medical University, India. She currently works as a senior cardiac physiologist and chief of non-invasive cardiac services at East Point Medical College Hospital, Bangalore, India. Her academic interest is focused on research into women and heart disease. Dr. Saravanan P is a Senior Interventional Cardiologist at East Point hospital. He holds a PhD in Cardiac Cellular Electrophysiology from the University of Manchester, UK. He has publications in several reputed international journals. He mentors young researchers in various disciplines of Cardiology.

Research Interest:

INTRODUCTION: Treadmill Test (TMT) is used to evaluate patients with chest pain. A positive TMT, defined as ST depression ≥ 1mm (as shown in figure-1A) is considered to indicate significant coronary artery disease (CAD). TMT has been shown to have low positive predictive value (PPV) of around 49% (1) with possible gender difference (2,3,4) but this has not been evaluated in Indian women. METHODS: In our study, over a 6-month period (April to September 2024) we prospectively evaluated patients with clinical suspicion of CAD and a positive TMT and corelated findings in Coronary Angiography (CAG). Patients were included when TMT was reported as positive and followed up to the day of CAG. Any stenosis more than 50% in one of the major epicardial coronary arteries or a significant branch vessel was considered to be positive. Data segregated as male and female and analyzed. RESULTS: 82 Patients (39 female-45%, 43 male- 55%) with positive TMT were included. Only 6 out of 39 female patients had significant CAD. Rest had either normal (15 pts) or minor CAD (18 pts). In contrast, 35 out of 43 male patients had significant CAD while 2 had normal coronaries and 6 minor CAD. The PPV in women was 15% and in men 81% as shown in FIGURE 1B. CONCLUSION: TMT has extremely low PPV of only 15% in Indian women leading to a large number (85%) of un-necessary invasive CAG. Hence, we should preferentially use alternative screening tools such as CT coronary angiography in women with suspected CAD in India.