Accuracy of Exercise Stress Test for Diagnosed Coronary Heart Disease Compared with 640-Slice Coronary Computed Tomographic Angiography or Invasive Coronary Angiography
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Abstract
Accuracy of Exercise Stress Test for Diagnosed Coronary Heart Disease Compared with 640-Slice Coronary Computed Tomographic Angiography or Invasive Coronary Angiography
Veerayut Anansawat 1, Hutsaya Prasitdumrong 2
1 Department of Internal Medicine, 2 Division of Cardiology
Department of Internal Medicine, Phramongkutklao hospital and College of Medicine
Background: Early diagnosis ischemic heart disease with Exercise Stress Test (EST) can prevent serious complications and death.
Objectives: To study the accuracy of morphological changed diagnosis during EST compared with coronary Computed Tomographic Angiography (CCTA) or invasive coronary angiography for coronary artery disease detection.
Methods: Cross sectional descriptive study was conducted. EST data during March 2012 to July 2015 were enrolled in this study. EST results were compared with the further Coronary CTA or CAG results.
Results: Among 2,450 patients who had performed EST, 458 patients (19%) had positive EST results. Mean age was 61 years and 76% were male. A total 136 patients (29%) had received Coronary CTA and 212 patients (46%) had received CAG. Coronary CTA or CAG revealed significantly coronary arteries stenosis, which was more than 70% luminal stenosis, in 210 patients (60%). There were 81 patients (23%) had single vessel disease, 67 patients (19%) had double vessel disease and 62 patients (18%) had triple vessel disease. Normal coronary arteries were found around 10% among positive EST patients. Sensitivity, specificity, positive predictive value and negative predictive value of positive EST to detect coronary heart disease were 62%, 72%, 75% and 58%, respectively.
Conclusions: EST is a good screening tool for early detection among patients who had symptom suspected ischemic heart disease.
Keywords: Exercise Stress Test, Coronary CTA, Coronary angiography
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References
Chaitman BR. Exercise Stress Testing. In: Bonow RO, Mann DL, Zipes DP, Libby P, editors. Braunwald’s Heart disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012. p. 168-199.
Sun Jian-ling ZY, Gao Yu-lian, Xiong Li-juan, Guo Ji-hong, Li Xiao-ying. Coronary heart disease diagnosis bases on the change of different parts in treadmill exercise test ECG. Cell Biochem Biophys.2013;67:969-75.
Korakoth Towashiraporn RK, Ahthit Yindeengam. Predicting Factors for a False Positive Treadmill Exercise Stress Test. J Med Assoc Thai. 2013;96:133-8.
Gianrossi R, Detrano R, Mulvihill D, Lehmann K, Dubach P, Colombo A, et al. Exercise-induced ST depression in the diagnosis of coronary artery disease. A meta-analysis. Circulation. 1989; 80(1):87–98.
Paech DC, Weston AR. A systematic review of the clinical effectiveness of 64-slice or higher computed tomography angiography as an alternative to invasive coronary angiography in the investigation of suspected coronary artery disease. BMC Cardiovasc Disord. 2011;11:32.
Mowatt G, Cook JA, Hillis GS, Walker S, Fraser C, Jia X, et al. 64-Slice computed tomography angiography in the diagnosis and assessment of coronary artery disease: systematic review and meta-analysis. Heart. 2008;94(11):1386–93.
Goldschlager N, Selzer A, Cohn K. Treadmill Stress Tests as Indicators of Presence and Severity of Coronary Artery Disease. Annals of Internal Medicine. 1976;85(3):277-86.