Coronary heart disease pretest probability

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pretest probability of coronary artery disease is assessed basing upon the age, gender and the symptoms. Patients are stratified into very low, low, intermediate, and high risk for CAD.[1]

Pretest Probability

Data exists for patients of age group 30 - 70 years. It can be assumed that risk/prevalence of coronary artery disease increases with age. Shown below is a tabulated form of pretest probabilities based upon age, gender, and symptoms. (Adapted from the presentation of Robert B. McCully,MD)

Age Gender Asymptomatic Non-Anginal Chest Pain Atypical Chest Pain

Typical Chest Pain

30 - 39 y Men Very Low Low Intermediate Intermediate
Women Very Low Very Low Very Low Intermediate
40 - 49 y Men Low Intermediate Intermediate High
Women Very Low Very Low Low Intermediate
50 - 59 y Men Low Intermediate Intermediate High
Women Very Low Low Intermediate Intermediate
60 - 69 y Men Low Intermediate Intermediate High
Women Low Intermediate Intermediate High

Key Points

  • Low Probability
    • Asymptomatic men and women of all ages.
    • Women of age < 50 years with atypical chest pain.
  • Intermediate Probability
    • Men of all ages with atypical angina.
    • Women > 49 years of age with atypical angina.
    • Women of age group 30 - 50 years with typical angina.
  • High Probability
    • Men > 39 years with typical angina.
    • Women > 59 years with typical angina.

References

  1. Messerli FH, Mancia G, Conti CR, Pepine CJ (2006). "Guidelines on the management of stable angina pectoris: executive summary: the task force on the management of stable angina pectoris of the European society of cardiology". European Heart Journal. 27 (23): 2902–3, author reply 2903. doi:10.1093/eurheartj/ehl308. PMID 17060344. Retrieved 2012-10-18. Unknown parameter |month= ignored (help)

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