Clinical Yield and Cost of Exercise Treadmill Testing to Screen for Coronary Artery Disease in Asymptomatic Adults

1998 ◽  
Vol 81 (2) ◽  
pp. 219-224 ◽  
Author(s):  
Louise Pilote ◽  
Fredric Pashkow ◽  
James D Thomas ◽  
Claire E Snader ◽  
Sharon A Harvey ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Treadmill Testing ◽  
Exercise Treadmill ◽  
Exercise Treadmill Testing ◽  
Artery Disease

scholarly journals Exercise treadmill tests in patients with low cardiovascular risk: are we wasting our time?

2016 ◽  
Vol 8 (3) ◽  
pp. 250
Author(s):  
Sarah Dixon ◽  
Judy Searle ◽  
Rachel Forrest ◽  
Bob Marshall
Keyword(s):  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Risk Group ◽  
Pain Clinic ◽  
Treadmill Testing ◽  
Exercise Treadmill ◽  
Exercise Treadmill Testing ◽  
Artery Disease ◽  
Low Cardiovascular Risk

ABSTRACT INTRODUCTION The efficacy and cost-effectiveness of exercise treadmill testing for patients with low cardiovascular risk is unclear. This is due to the low incidence of coronary artery disease in this population and the potential for false-positive results leading to additional invasive and expensive investigation. AIM To investigate the value of exercise treadmill testing (ETT) as a predictor of coronary artery disease in patients with different levels of cardiovascular risk. METHODS An observational study was completed on an outpatient population from a chest pain clinic (n = 529). Cross-tabulations and binary logistic regressions were used to examine relationships between variables. RESULTS A negative ETT result was recorded for 72.5% of patients with low cardiovascular risk compared to 54.3% of those with moderate or high risk. Within the low cardiovascular risk group, patients with symptoms atypical for cardiac ischaemia were 11.1-fold more likely to have a negative ETT result. Of the patients with positive or equivocal ETT results, coronary artery disease was subsequently confirmed in only 23.1% of the low cardiovascular risk group compared to 77.2% of those with moderate or high cardiovascular risk. DISCUSSION Results show low cardiovascular risk patients are significantly more likely to return negative ETT results, particularly when associated with atypical symptoms. Similarly, positive or equivocal ETTs in this group are significantly more likely to be false positives. This suggests the ETT is not efficacious in predicting coronary artery disease in patients with low cardiovascular risk. Is it therefore appropriate to offer exercise testing to this cohort or should alternative management strategies be considered?

Sex and diagnostic evaluation of possible coronary artery disease after exercise treadmill testing at one academic teaching center

1997 ◽  
Vol 134 (5) ◽  
pp. 807-813 ◽  
Author(s):  
Michael S. Lauer ◽  
Fredric J. Pashkow ◽  
Claire E. Snader ◽  
Sharon A. Harvey ◽  
James D. Thomas ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diagnostic Evaluation ◽  
Academic Teaching ◽  
Treadmill Testing ◽  
Exercise Treadmill ◽  
Exercise Treadmill Testing ◽  
Teaching Center ◽  
Artery Disease

scholarly journals The Diagnostic Accuracy of Exercise Treadmill Testing and Stress Echocardiography for the Detection of Obstructive Coronary Artery Disease in Patients Aged ≥ 70 Years

Kardiologiia ◽  
2019 ◽  
Vol 59 (10) ◽  
pp. 23-30
Author(s):  
S. G. Kozlov ◽  
O. V. Chernova ◽  
Viktor Nikolaevich Shitov ◽  
M. A. Matveeva ◽  
I. A. Alekseeva ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Stress Echocardiography ◽  
Anginal Pain ◽  
Treadmill Testing ◽  
Exercise Treadmill ◽  
Exercise Treadmill Testing ◽  
Artery Disease

Aim: to compare diagnostic accuracy of exercise treadmill testing and stress echocardiography in the diagnosis of stable coronary artery disease (CAD) in patients aged >70 years.Materials and methods. The study included 390 patients aged >70 years with suspected stable ischemic heart disease, who underwent elective coronary artery angiography (CAG). Exercise treadmill testing (ETT) according to the modified Bruce protocol was carried out in 189 patients (48 %), bicycle stress echocardiography - in 179 patients (46 %). Initially we determined the prevalence of angiographically significant CAD according to the gender and chest pain character, and identified persons in whom stress testing was appropriate. After that diagnostic accuracy of both tests was evaluated in patients with atypical angina and non-anginal chest pain.Results. Among 72 patients with atypical angina and non-anginal pain who underwent ETT and had unequivocal results, 38 (53 %) had obstructive CAD. ETT for detection of obstructive CAD had sensitivity 79 %, specificity 82 %, positive likelihood ratio (LR+) 4.4, and negative likelihood ratio (LR-) 0.3. Positive result increased probability of obstructive CAD from 53 % to 83 %, negative result reduced probability of obstructive CAD to 25 %. Among 111 patients with atypical angina and non-anginal pain who underwent stress echocardiography and had unequivocal results, 69 (62 %) had obstructive CAD. Sensitivity, specificity, LR+, and LR- of stress echocardiography were equal to 89 %, 95 %, 17.8, and 0.1, respectively. Positive result increased probability of obstructive CAD from 62 % to 95 %, negative result reduced probability of obstructive CAD to 16 %.Conclusion: bicycle stress echocardiography was found to be more accurate than ETT to rule in or rule out obstructive CAD in patients aged ≥ 70 years with atypical angina and non-anginal pain.

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