Prevalence and significance of an abnormal exercise ECG in asymptomatic males. Outcome of thallium myocardial scintigraphy.
During a 3-year period 2500 asymptomatic male aviators were screened routinely for coronary artery disease by maximal bicycle exercise testing. In 55 cases (2.1%) the exercise ECG was abnormal (40 subjects exhibited ST depression, 14 ventricular ectopic activity and in one subject both abnormalities were observed). Further non-invasive studies (Thallium scintigraphy, echocardiography and ambulatory ECG monitoring for arrhythmias) identified nine out of the 55 aviators (16%, 95% CL = 7-26%) with an abnormal exercise test as having cardiac disease. We conclude that standard exercise ECG by itself is a poor predictor of coronary artery disease in asymptomatic subjects because of too many false-positives when the pre-test likelihood of disease is low. Therefore, exercise electrocardiography cannot be recommended as the single routine screening test for coronary artery disease in such individuals.
Pedersen
F
F
Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, University Hospital of Copenhagen, Denmark.
Sandøe
E
E
Laerkeborg
A
A
D000328:Adult; D000337:Aerospace Medicine; D001145:Arrhythmias, Cardiac / Q000175:diagnosis; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004452:Echocardiography; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005189:False Positive Reactions; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D011877:Radionuclide Imaging; D012307:Risk Factors; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes