Factors Associated with False Positive Treadmill Exercise Stress Test Results

Authors

  • Viroj Muangsillapasart Cardiovascular Division, Department of Internal Medicine, Phramongkutklao Hospital
  • Chompol Piamsomboon Cardiovascular Division, Department of Internal Medicine, Phramongkutklao hospital
  • Sopon Sanguanwong Cardiovascular Division, Department of Internal Medicine, Phramongkutklao hospital
  • Preecha Uerojanaungkul Cardiovascular Division, Department of Internal Medicine, Phramongkutklao hospital
  • Nakarin Sansanayudh Cardiovascular Division, Department of Internal Medicine, Phramongkutklao hospital
  • Waraporn Tiyanon Cardiovascular Division, Department of Internal Medicine, Phramongkutklao hospital
  • Thoranis Chantrarat Cardiovascular Division, Department of Internal Medicine, Phramongkutklao hospital
  • Verapon Pinphanichakarn Cardiovascular Division, Department of Internal Medicine, Phramongkutklao hospital
  • Tanyarat Aramsaruwong Cardiovascular Division, Department of Internal Medicine, Phramongkutklao hospital
  • Hutsaya Prasitdumrong Cardiovascular Division, Department of Internal Medicine, Phramongkutklao hospital

Keywords:

exercise stress test, coronary computed tomography angiography, coronary angiography

Abstract

Background: The treadmill exercise stress test (EST) is predominantly performed in patients who are symptomatic or suspected of having ischemic heart disease. This study was conducted to study the factors associated with false positive EST results for CAD.

Methods: This was a cross-sectional study. Patients who obtained a positive EST result at the Cardiovascular Division, Department of Internal Medicine, Phramongkutklao Hospital, and who subsequently underwent coronary angiography (CAG) or coronary computed tomography angiography (CCTA) between October 2013 and October 2016 were included. Patients were divided into two groups, true positive and false positive, depending upon the CCTA and CAG data. The two groups were compared with each other.

Results: One hundred and seventy-two patients were included, 67% of whom were male. Ninety-five (55.2%) patients, most of whom were male (65.3%), had a false positive EST result. The mean age in the true positive group was 64.6 years, and that in the false positive group was 59.7 years. There was no significant difference in blood pressure response between the two groups. In the univariate analysis, in female patients, risk factors, including diabetes and dyslipidemia, appropriate heart rate responsiveness, upslope ST depression, and downslope ST segment depression confined to the inferior leads, had a statistically significant correlation between groups. Multivariate analysis to determine the independent predictors of a false positive EST result identified female sex (odds ratio [OR], 3.90; 95% confidence interval [CI], 1.36–11.18; p = 0.011) and upslope ST segment depression (OR, 74.03; 95% CI, 7.74–707.65; p < 0.001). The most commonly involved vessel was the left anterior descending artery (62, 81.58%), followed by the right coronary artery (52, 67.53%), and the left circumflex artery (49, 63.64%).

Conclusions: Female sex and upslope ST segment depression are associated with false positive EST results.

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Percentage of true and false positives among patients with a positive EST result

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Published

2022-07-11

How to Cite

1.
Muangsillapasart V, Piamsomboon C, Sanguanwong S, Uerojanaungkul P, Sansanayudh N, Tiyanon W, Chantrarat T, Pinphanichakarn V, Aramsaruwong T, Prasitdumrong H. Factors Associated with False Positive Treadmill Exercise Stress Test Results. J Chulabhorn Royal Acad [Internet]. 2022 Jul. 11 [cited 2022 Oct. 3];4(3):103-10. Available from: https://he02.tci-thaijo.org/index.php/jcra/article/view/253295

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