Key result
Incorporating the QRS score into standard ST-segment criteria improved the diagnostic accuracy of treadmill exercise testing for detecting coronary artery disease from 50% to 87% in women.
Why the study?
Does the incorporation of QRS score improve the diagnostic accuracy of treadmill exercise testing to detect coronary artery disease in women?
Observational (n=114)
Does the incorporation of QRS score improve the diagnostic accuracy of treadmill exercise testing to detect coronary artery disease in women?
Absolute Event Rate: 87% vs 50%
Adding QRS score to standard ST-segment criteria during treadmill exercise testing significantly improves diagnostic accuracy for coronary artery disease in women, primarily by reducing false positives.
May improve exercise test accuracy for CAD in women; hypothesis-generating and requires prospective validation before practice change.
OBJECTIVE: The accuracy of treadmill exercise testing to detect coronary artery disease is limited in women. This study was undertaken to evaluate whether QRS score can improve the accuracy of treadmill exercise testing in women. METHODS: The study population consisted of 114 women with angina-like symptoms, who underwent both treadmill exercise testing and coronary angiography. The impact of QRS score on the standard ST-segment based diagnostic ability of treadmill exercise testing to detect coronary artery disease was studied. RESULTS: Incorporation of QRS score in standard ST-segment diagnostic criteria significantly enhanced sensitivity (from 59 to 80%), specificity (from 40 to 94%) and diagnostic accuracy (from 50 to 87%) of treadmill exercise testing. The QRS score was shown to reduce significantly the false-positive results from 60 to 6%. Furthermore, QRS score accuracy was correlated with the extent of coronary artery disease. The diagnostic ability of QRS score was greater both among patients with normal and impaired systolic function of the left ventricle. CONCLUSIONS: QRS score can improve the limited diagnostic accuracy of treadmill exercise testing in women, by predominantly decreasing the high prevalence of false-positive results.
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Fourlas et al. (2007) conducted an observational in Suspected coronary artery disease (n=114). QRS score incorporated into standard ST-segment criteria vs. Standard ST-segment criteria alone was evaluated on Diagnostic accuracy for detecting coronary artery disease. Incorporating the QRS score into standard ST-segment criteria improved the diagnostic accuracy of treadmill exercise testing for detecting coronary artery disease from 50% to 87% in women.
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