ST-changes in ECG at rest or during exercise indicate a high risk of severe coronary lesions after an episode of unstable coronary artery disease.
After an episode of unstable coronary artery disease, 190 patients performed a predischarge exercise test. A postdischarge exercise test and coronary angiography was performed by 172 patients after 1 month. A subgroup of 104 men performed both exercise tests with a computer-aided system. More sophisticated methods of evaluating the ECG reaction during exercise were not diagnostically superior to the simple identification of ST-depression of > or = 0.1 mV. ST-depression in ECG at rest indicated a 70% risk of severe coronary lesions and in such patients, the ECG reaction at exercise carried no additional diagnostic information. Stepwise multiple regression analysis showed that ST-depression and low maximal work load were the most important exercise variables for identification of severe coronary lesions. Using a combination of these parameters, the sensitivity and specificity for identification of severe coronary lesions were, respectively, 77% and 61% predischarge and 77% and 70% after 1 month.
Karlsson
J E
JE
Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden.
Björkholm
A
A
Nylander
E
E
Ohlsson
J
J
Swahn
E
E
Wallentin
L
L
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D004311:Double-Blind Method; D004562:Electrocardiography / Q000379:methods*; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D010959:Tissue Plasminogen Activator