- Paper Report
- Open Access
Noninvasive tests for CAD unsuitable in renal failure patients
- Joanna Lyford1
© Biomed Central Ltd 2001
- Received: 7 March 2001
- Published: 18 October 2001
- Coronary artery disease, diagnosis, mass screening, sensitivity, specificity
It was thought that many common tests for coronary artery disease (CAD) are considered to be of little use in patients with end-stage renal disease. This paper tested the accuracy of some common tests.
Angina pectoris was the clinical symptom that most accurately predicted the presence of CAD, with a sensitivity of 65% and a specificity of 66%. The corresponding positive and negative likelihood ratios were 1.9 and 0.5. Neither resting ECG, which had a sensitivity of 67% and a specificity of 52%, nor dipyridamole thallium-201 scintigraphy, which had a 1.3 positive likelihood ratio and a 0.5 negative likelihood ratio, were useful in diagnosing CAD. The sensitivity of exercise testing was also low, since most patients were not physically able to complete the test.
Various tests for CAD were evaluated, including clinical symptoms, electrocardiography (ECG), angiography, dipyridamole thallium-201 scintigraphy, and exercise testing. In total, 84 patients were studied; 42 were on hemodialysis and 42 were renal transplant patients. Angiography results that 43 (51%) had significant CAD.