Coronary heart disease pretest probability

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.

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.