Value of Duke Treadmill Score in Setting Priority of Patients for Coronary Angiography

Background: exercise treadmill test remains a good test in identification of coronary artery disease(CAD). The Duke Treadmill Score (DTS), shown to predict CAD better than ST segment deviation alone. Aim of the work: To determine the potential of DTS in setting priority of patients for coronary angiography. Patients and methods: This was a prospective study that was done from July 2017 to October 2018 and included 150 patients referred to Damannhour Teaching Hospital for evaluation of chest pain. Patients underwent: history, clinical examination, ECGs, Echocardiography, Treadmill exercise ECG with calculation of DTS then coronary angiography that was correlated with DTS and other variables. Results: There were 59 patients(39.3%)with high DTS and 91patients (60.7%) with intermediate DTS. For the intermediate Duke's risk group the result of coronary angiography distributed on normal (26.4%), single vessel disease (33%), two vessel disease (22%), and three vessels disease or left main disease (18.7%). For high Duke's risk group the result of coronary angiography showed mainly three vessels disease or left main disease (54.2%), two vessels disease (27.1%), single vessel disease (6.8%) and normal vessel (11.9%), The P value was<0.001.Adding patient's risk factors to intermediate DTS group were statistically significant in the diagnosis of CAD ,the P value was<0.001. Conclusion: The DTS is a good predictor for CAD. Intermediate risk DTS group exercise test results should be managed individually according to clinical data.