Prognostic value of profound ST segment depression during treadmill stress test in coronary heart disease: nine years follow-up study.
To define the prognostic significance of profound ST segment depression (greater than or equal to 3mm) during exercise test, 106 patients of definite coronary heart disease enrolled in a prospective study were followed for up to 9 years. Group A (56 patients) had profound (greater than or equal to 3mm) ST segment depression (3.56 +/- 0.74mm) and Group B (50 patients) had less than 3mm ST segment depression (1.23 +/- 0.35mm, P less than 0.01) during treadmill testing. Group A patients tolerated exercise for a lesser duration in comparison to group B patients (7.22 +/- 3.35 vs. 10.18 + 4.07 minutes, p less than 0.01). At the end of the study, 21 (37.5%) group A patients either died or underwent coronary artery bypass surgery as compared to 8 (16.0%) group B patients (p = 0.02). The difference in the incidence of cardiac deaths between the two groups was not statistically significant (19.6% in group A and 14.0% in group B). However, sudden deaths were significantly more common in group A as compared to group B patients (10 of 11 (90.9%) vs 4 of 7 (57.1%), p = 0.02). These data suggest that profound ST segment depression (greater than 3mm) during treadmill stress test indicates an adverse long term prognosis with the risk in particular, of sudden cardiac death.
Gupta
R
R
K.D. Gupta Medical Centre, Jaipur.
Kanodia
V K
VK
Gupta
K D
KD
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000401:mortality / Q000503:physiopathology*; D016757:Death, Sudden, Cardiac; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies