验前概率联合运动平板试验对冠心病的诊断价值及在性别间的差异OACSTPCD

Objective To investigate the diagnostic value and gender differences of pre-test probability(PTP)combined with exercise treadmill test(ETT)in coronary heart disease(CHD).Methods Patients suspected of CHD and admitted to Chengde Central Hospital from June 2019 to April 2023 were consecutively included as research subjects.PTP was calculated for each patient,and ETT was performed.The probability of CHD was preliminary assessed,and coronary angiography(CAG)was performed.Using CAG results as the"gold standard",and the diagnostic value of PTP combined with ETT for CHD and gender differences were explored.Results Among 548 suspected CHD patients who underwent CAG,381 cases(69.53%)were diagnosed with CHD,including 221 males(58.01%)and 160 females(41.99%).Taking CAG results as the"gold standard",346 patients were diagnosed with CHD by PTP combined with ETT,with a total consistent rate of 90.81%,including 211 males and 135 females.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PTP combined with ETT for diagnosing male CHD patients were 95.48%,89.77%,93.85%,95.91%and 88.76%,respectively,showing excellent consistency with CAG(Kappa=0.847).For female CHD patients,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PTP combined with ETT were 84.38%,79.75%,82.85%,89.40%,and 71.59%respectively,demenstrating ideal consistency with CAG(Kappa=0.580).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PTP combined with ETT in the diagnosis of male CHD patients were higher than those in female patients.Conclusion PTP combined with ETT has a high diagnostic value for CHD,with better diagnostic efficacy for male CHD patients than for female CHD patients.