Exercise testing added substantially more diagnostic information than clinical data alone in men with probable angina, reducing the probability of multivessel disease to <10% for 30% of patients.
Observational (n=1,351)
Does maximal exercise treadmill testing combined with clinical data improve the prediction of the presence and extent of coronary artery disease compared to clinical data alone in men with chest pain?
Exercise treadmill testing provides important incremental diagnostic value over clinical data alone for predicting the presence and extent of coronary artery disease in men with definite or probable angina.
Multivariate linear discriminant function analysis on maximal exercise treadmill and angiographic data from 500 men with definite angina, 584 men with probable angina and 267 men with nonspecific chest pain identified independent predictors of presence and extent of coronary disease. We used the discriminant function to develop a clinical risk index and a clinical and exercise risk index for each patient subset. Probability curves were generated to predict the presence and extent of coronary disease. In definite angina cases, exercise testing provided more diagnostic information than clinical data alone. However, in the 10% of cases with the smallest risk indexes, half of the patients had coronary disease and one-quarter had multivessel disease. In men with probable angina, exercise testing added substantially more diagnostic information than clinical data. The probability of multivessel disease was reduced to less than 10% for 30% of patients with probable angina, an important diagnostic contribution. Exercise testing in men with nonspecific chest pain was of limited value because disease prevalence was already low.
Fisher et al. (1981) conducted an observational in Coronary artery disease (n=1,351). Clinical and exercise risk index vs. Clinical data alone was evaluated on Presence and extent of coronary disease. Exercise testing added substantially more diagnostic information than clinical data alone in men with probable angina, reducing the probability of multivessel disease to <10% for 30% of patients.