Chest
Exercise and the HeartSimple Treadmill Score To Diagnose Coronary Disease
Section snippets
Veterans Affairs Score Development Population
Eight thousand male patients underwent treadmill testing at two Veterans Affairs (VA) medical centers between 1987 and 1998. Of these patients, 3,454 were evaluated for chest pain with coronary angiography within 3 months of treadmill testing. Patients with previous cardiac surgery or angiography, valvular heart disease, left bundle-branch block, paced rhythms, or Wolff-Parkinson-White syndrome on their resting ECG were excluded from the study. Since neither medications nor resting ST-segment
Population Characteristics
Of the 1,282 veterans included in this study, 759 patients (59%) had clinically significant CAD, 302 patients (24%) had multivessel disease, and 523 patients (41%) were without any CAD; the 476 men in the validation group from West Virginia University Medical Center had a 46% prevalence of CAD (Table 1) . Overall, the CAD group of patients was older compared to patients without CAD in both the populations. The CAD groups had a higher prevalence of hypertension, diabetes, and
Discussion
Recommendations have been made for assigning patients to low-, intermediate-, or high-probability groups based on clinical criteria in order to provide a strategy for patient man agement.21 The use of a score for diagnostic purposes represents a compromise between the simplicity of designating arbitrary high probability, intermediate and low probability, and the accuracy of detailed logistic regression models.22 Probability of disease subgrouping is appealing because the classification scheme
Conclusion
This clinical scoring method is an accurate and simple method for categorizing patients with suspected coronary disease into clinically meaningful groups for which decisions concerning patient man agement can be based. We have demonstrated that the score is portable and is diagnostically superior to standard exercise testing interpretation.
Morise Pretest Score
age code + (angina pectoris code × 5) + (diabetes × 2) + hypertension + smoking now + hypercholesterolemia + family history of CAD + obesity,
where age < 40 = 3 points, age between 40 years and 55 years = 6 points, and age > 55 years = 9 points. For estrogen status, 3 points were subtracted for positive status and 3 points were added for negative status. Typical chest pain = 5 points, atypical chest pain = 3 points, nonanginal chest pain = 1 point, and no chest pain = 0 points. For diabetes
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PCI Alternative Using Sustained Exercise (PAUSE): Rationale and trial design
2019, Contemporary Clinical TrialsDiagnostic accuracy of treadmill exercise tests among Chinese women with coronary artery diseases: A systematic review and meta-analysis
2017, International Journal of CardiologyDetection of stress-induced myocardial ischemia from the depolarization phase of the cardiac cycle-a preliminary study
2009, Journal of ElectrocardiologyCitation Excerpt :Multiple studies aimed at improving the diagnostic and prognostic capabilities of ECG interpretation have been conducted with variable success.22-24 In addition, several studies emphasized nonelectrocardiographic measures such as exercise capacity, chronotropic response, heart rate recovery, and ventricular ectopy.1,25-28 Although most ECG-based ischemia detection techniques are based on refining conventional ST analysis, the current study was aimed at the clinical validation of a novel technique for electrocardiographic ischemia detection.
Determining the need for coronary revascularization by an exercise test assessment computer program (ETAP)
2004, European Journal of Internal MedicineEffect of age and end point on the prognostic value of the exercise test
2004, ChestCitation Excerpt :Exercise-induced ST-segment depression was significantly more prevalent in those who died, but it was independently associated with cardiovascular mortality only in those 45 to 55 years of age. The failure of the Duke treadmill angina score to have prognostic value in our population remains a mystery since in the very same population using the same protocol for data collection, it is one of the important predictors for the presence of angiographic disease.21 Our study considered a large number of patients who underwent treadmill testing for clinical indications in a general hospital/clinic setting.
Treadmill scores in elderly men
2004, Journal of the American College of CardiologyCitation Excerpt :Delta PRP was calculated as follows: PRP at maximal exercise minus PRP at rest/1,000. A previously validated treadmill angiographic score was calculated in each patient (18). Coronary artery narrowing was visually estimated and expressed as percent lumen diameter stenosis.