FREQUENCY OF ORAL ESTROGEN REPLACEMENT THERAPY IN WOMEN WITH NORMAL AND ABNORMAL EXERCISE ELECTROCARDIOGRAMS AND NORMAL CORONARY-ARTERIES BY ANGIOGRAM

The specificity of the exercise electrocardiogram has been reported to be lower in women than in men.1 Using different standards, other investigators have reported no difference.2 Nevertheless, there exists a relative consensus in the practicing medical community that a positive exercise electrocardiogram is of inherently less value in women than in men. Although one cannot discount the role that a lower prevalence of coronary artery disease in women3 may play in this false-positive predisposition (i.e., reduced positive predictive accuracy), several authorities have speculated on a possible role for estrogen as a direct contributor to the false-positive exercise electrocardiogram in women (i.e., reduced specificity).1,4 This study reviews our experience with exercise electrocardiography in women without atherosclerotic coronary artery disease by angiogram and assesses whether estrogen was associated with (false)-positive ST-segment changes. © 1993.