Key result
The modified ST/HR score achieved a significantly higher sensitivity of 96% for predicting coronary artery disease compared to 57% for standard ST criteria during treadmill exercise testing.
Why the study?
Does the ST/HR slope and modified ST/HR score improve the diagnostic accuracy for coronary artery disease compared to standard ST criteria in patients undergoing exercise testing?
Observational (n=79)
No
Does the ST/HR slope and modified ST/HR score improve the diagnostic accuracy for coronary artery disease compared to standard ST criteria in patients undergoing exercise testing?
Absolute Event Rate: 96% vs 57%
p-value: p=<0.001
The modified ST/HR score (MSHS) during standard treadmill exercise testing provides a high diagnostic yield (96%) for detecting and assessing the severity of coronary artery disease.
May support refined CAD detection on exercise testing; hypothesis-generating and requires prospective validation before practice change.
Elaminらの提唱したST/HR slopeを標準多段階運動負荷試験に応用し,冠動脈疾患(CAD)の有無とその重症度診断における有用性を他の診断基準と比較検討した.さらにこれを改良した修正ST/HR score (MSHS)を考案し,その診断的価値を検討した.冠動脈造影施行79例で,運動負荷時のaVFとV5誘導のST indexとST/HR slopeを算出した. CAD患者の診断率は,通常のST判定基準とST indexでは57%と71%であり, ST/HR slopeでも72%であった. ST/HR slopeでのみCAD中の3枝病変の診断が可能であった. MSHSではCAD診断率は96%と良好で, CAD重症度判定も可能であった. ST/HR slopeは3枝病変の診断に,それを改良したMSHSはCADの有無と重症度診断に有用であると思われた.
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Keta et al. (1987) conducted an observational in Coronary artery disease (n=79). Modified ST/HR score (MSHS) vs. Standard ST criteria was evaluated on Sensitivity for predicting coronary artery disease (p=<0.001). The modified ST/HR score achieved a significantly higher sensitivity of 96% for predicting coronary artery disease compared to 57% for standard ST criteria during treadmill exercise testing.
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