The Value of Exercise Treadmill Test in Evaluation of Coronary Artery Disease

Objective: To evaluate the value of Exercise treadmill test (ETT) in the diagnosis of coronary artery disease (CAD). Methods: Here we reviewed 142 (men, 104, mean age, 52.7±8.6) consecutive patients admitted to the 4th Clinical Hospital of Harbin Medical University for suspicion of CAD and they underwent ETT before coronary angiography (CAG). Patients were divided into four groups to see the sensitivity of different ETT criteria: group I: ETT negative, group II: ETT positive (ST-segment depression ≥0.1mv for more than 2 minutes), group III: ETT positive (exercise induced chest pain), group IV: ETT positive (exercise induced chest pain and ST-segment depression). The severity of coronary artery stenosis was assessed by CAG, only those with >50% of narrowing in at least one of the three major arteries or their first-order branches was considered CAG positive. Results: The false negative rate was 30.6% and the accuracy rate was 69.4% in group I. In group II, III and IV, the accuracy rates and false positive rates were 53.7% and 46.3%, 78.6% and 21.4%, 86.7% and 13.3%, respectively, (p<0.05). Furthermore, we analyzed the data of male patients in each group and the accuracy rates were 67.9%, 60.7%, 76.9%, 100%, respectively, (p<0.05). Multivariate logistic regression results showed that ST-segment depression together with exercise induced chest pain were the most related factors in CAD diagnosis. Conclusion: ST-segment depression and exercise induced chest pain are the strongest factors in CAD diagnosis. Chest pain combined with ST-segment depression had a much higher accuracy rate than ST-segment depression alone.