DIAGNOSTIC EVALUATION OF WOMEN WITH SUSPECTED CORONARY-ARTERY DISEASE

Women are less likely than men to be referred for coronary angiography. It is unclear whether this reflects good clinical judgment or agenda bias. The decision to refer a patient for an invasive evaluation depends upon the prevalence of disease and the population in question, the prognosis of patients with coronary artery disease and the response of these patients of the available therapies. This paper reviews the statistical basis for clinical decision making and the available epidemiologic and risk factor data in women with suspected coronary artery disease. The results of noninvasive testing in women are also reviewed, Finally, guidelines are suggested to help determine when a woman with suspected coronary artery disease should be referred for coronary angiography.