Evaluation of coronary artery disease in women

Diagnostic techniques have been refined to improve the accuracy of coronary artery disease detection in women compared to that achieved by clinical assessment and stress electrocardiography alone. Noninvasive cardiac imaging with 99mTc myocardial perfusion agents improves the specificity of coronary artery disease diagnosis over that achieved with 201Tl imaging, particularly when this technique is combined with ECG-gated image analysis. Improvements in diagnostic accuracy should enhance physician confidence in the use of noninvasive diagnostic testing in women. Combined clinical and noninvase imaging assessment can define those women at very high and very low risk for future cardiac events, permitting physicians to direct appropriate patients to aggressive treatment (ie, coronary revascularization) to improve outcomes. The reduction in unneccessary coronary cardiac catheterization accomplished by improved specificity, and the accurate determination of cardiac risk, provides for the most cost-efficient use of medical resources in the female population with known or suspected coronary artery disease.