The importance of clinical subsets in interpreting maximal treadmill exercise test results: the role of multiple-lead ECG systems.
Key result
14-lead treadmill testing achieves 100% positive predictive value in men with typical angina.
- P<0.001
- n=200
Why the study?
The diagnostic value of maximal treadmill exercise testing using multiple-lead ECG systems varies among clinical subsets of men with normal resting ECGs and chest pain symptoms.
Does the clinical subset of chest pain affect the predictive value of maximal treadmill testing using 14 ECG leads for detecting coronary stenoses?
Comparison
Maximal treadmill exercise test using 14 ECG leads vs coronary arteriogram
Design
Observational cross-sectional study
Authors
Discussion
Loading...
Member takes
Implication
Pretest probability may guide 14-lead treadmill interpretation in men; leaves open prospective validation before changing diagnostic pathways.
Study Design
Type
Observational (n=200)
Structured PICO
Does the clinical subset of chest pain affect the predictive value of maximal treadmill testing using 14 ECG leads for detecting coronary stenoses?
P
Population
200 men with normal resting ECGs and suspected coronary disease who underwent maximum treadmill testing 1 day before coronary arteriography.
E
Exposure
Maximal treadmill exercise test using 14 ECG leads.
C
Comparator
Coronary arteriogram (reference standard for coronary stenoses ≥70%).
O
Outcome
Predictive value of a positive or negative treadmill test for coronary stenoses ≥70%.surrogate
Main Result
Absolute Event Rate: 100% vs 45%
p-value: p=< 0.001
The diagnostic value of a 14-lead maximal treadmill test is highly dependent on the pre-test clinical probability of coronary artery disease, being most useful in men with typical or probable angina.
Cite This Study
Chaitman et al. (1979) conducted an observational in Suspected coronary artery disease (n=200). Maximal treadmill testing using 14 ECG leads vs. Clinical subsets (nonspecific chest pain) was evaluated on Predictive value of a positive test in any one of 14 leads (p=< 0.001). Maximal treadmill testing using 14 ECG leads had a positive predictive value of 100% in men with typical angina, 82% in probable angina, and 45% in nonspecific chest pain (p<0.001).