Patients with ST-segment depression restricted to the recovery phase had the highest specificity (96.92%) and positive predictive value (96%) for diagnosing significant coronary artery disease.
Cross-Sectional (n=300)
No
Does ST-segment depression restricted to the recovery phase of an exercise stress test improve the diagnosis of significant coronary artery disease in patients with a positive treadmill test?
ST-segment depression restricted to the recovery phase of an exercise stress test is highly specific for significant coronary artery disease, though overall diagnostic accuracy is highest when depression occurs in both stress and recovery phases.
Tasa de eventos absoluta: 96% vs 88.9%
OBJECTIVE: To study the significance of ST-segment depression during 'recovery' compared to that 'during stress' and 'both the phases' in exercise stress test. METHODS: Patients with positive exercise stress test who underwent coronary angiography (CAG) from 1st January 2017 to 31st December 2018 were studied. Patients were divided into 3 groups- Group A with ST-depression restricted to recovery phase, group B with ST-depression restricted to stress phase and group C with ST-depression seen both during exercise and recovery. All patients underwent CAG. Sensitivity, specificity, and predictive values of each of these groups in diagnosis of significant coronary artery disease (CAD) were analysed and compared. RESULTS: Total 300 patients were studied. Mean age of the study population was 48.77 ± 7.94 years. 78.3% of patients with positive exercise stress test had significant CAD. 96% of patients in group A had significant CAD, which was higher than in group B (88.9%) & group C (70.1%). The specificity, positive predictive value and negative predictive value of ST-segment depression in group A (96.92%, 96% and 25.2% respectively) were higher than that of ST-depression in group B (89.23%, 88.89% and 24.47% respectively) and group C (13.85%, 70.05% and 7.96% respectively). Sensitivity and accuracy of ST-depression in group A were lower (20.43% and 37% respectively), compared to other 2 groups. CONCLUSION: Patient with ST-depression restricted to recovery phase had highest specificity, positive predictive value, and negative predictive value. However, accuracy was highest in group with both stress phase and exercise ST-segment depression.
Katheria et al. (Thu,) conducted a cross-sectional in Coronary artery disease (n=300). ST-segment depression restricted to recovery phase vs. ST-segment depression during stress phase or both phases was evaluated on Significant coronary artery disease (>50% stenosis on angiography). Patients with ST-segment depression restricted to the recovery phase had the highest specificity (96.92%) and positive predictive value (96%) for diagnosing significant coronary artery disease.