Angiographic correlates of the treadmill scores in non-high-risk patients with unstable angina.
BACKGROUND
There has been no clear consensus regarding the optimum definition of a high-risk exercise ECG test. The aim of this study is to compare the diagnostic accuracy of several treadmill scores [American College of Cardiology/American Heart Association (ACC/AHA) High-Risk Criteria for exercise testing, Duke Treadmill Score, Veterans Affairs and West Virginia Prognostic Score, ST/Heart Rate Index] with the ST-segment depression analysis in the detection of significant and severe coronary disease as determined by coronary angiography.


METHODS
The study included a cohort of 248 consecutive patients admitted to hospital for unstable angina.


RESULTS
The sensitivities of the ACC/AHA High-Risk Criteria and the ST depression > or =1 mm were 89.02 and 76.83%, respectively, for the detection of significant coronary artery disease, and 96.15 and 86.54% for the detection of severe coronary artery disease. The specificities of the Duke Treadmill Score and the ST depression > or=1 mm were 96.43 and 73.81%, respectively, for the detection of significant coronary artery disease, and 81.63 and 47.45% for the detection of severe coronary artery disease.


CONCLUSIONS
The ACC/AHA High-Risk Criteria and Duke Treadmill Score provided relevant diagnostic information not available from the ST segment analysis alone.
Alvarez Tamargo
José A
JA
Unidad de Cardiología, Hospital Carmen y Severo Ochoa, Cangas del Narcea, España. joseantonio.alvarezt@sespa.princast.es
Simarro Martín-Ambrosio
Eugenio
E
Romero Tarín
Enrique
E
Martín Fernández
María
M
Hevia Nava
Sergio
S
Barriales Alvarez
Vicente
V
Morís de la Tassa
Cesar
C
D000368:Aged; D000789:Angina, Unstable / Q000150:complications*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology; D004562:Electrocardiography / Q000592:standards*; D005080:Exercise Test / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests