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Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Role of ETT to diagnose coronary artery disease
R C Debnath1, M A Siddique, S S Haque
1Department of Cardiology, Mymensingh Medical College, Mymensingh, Bangladesh.
Insights
High exercise treadmill test scores accurately predict coronary artery disease, especially multi-vessel disease. This indicates a high probability of significant stenosis, warranting urgent coronary angiography.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Preventive Medicine
Background:
- Coronary artery disease (CAD) diagnosis relies on various methods, with exercise treadmill testing (ETT) being a common non-invasive tool.
- Understanding the correlation between ETT scores and angiographic findings is crucial for accurate patient stratification and management.
- Prevalence of risk factors like dyslipidemia, hypertension, and diabetes highlights the burden of CAD in the studied population.
Purpose of the Study:
- To predict coronary artery disease using the exercise treadmill scoring system.
- To correlate the angiographic extent of coronary artery disease with high treadmill scores.
- To assess the diagnostic utility of ETT in identifying significant coronary stenosis.
Main Methods:
- Prospective study involving 80 patients with chronic stable angina or chest pain evaluation.
- Inclusion criteria: positive ETT, admission to University Cardiac Centre, and coronary angiogram within one month.
- Data collection included patient demographics, risk factors, ETT results, and coronary angiogram findings (normal, SVD, DVD, TVD).
Main Results:
- High probability ETT scores predicted significant stenosis in approximately 70% of cases.
- High probability ETT scores accurately predicted multi-vessel coronary artery disease in 82.8% of patients.
- Dyslipidemia (90%) and hypertension (68.8%) were the most prevalent risk factors among the study population.
Conclusions:
- Exercise treadmill test scores are effective in predicting the presence and extent of coronary artery disease.
- A high probability ETT score strongly suggests significant coronary stenosis and multi-vessel disease, necessitating urgent coronary angiography.
- ETT serves as a valuable tool for risk stratification in patients presenting with symptoms suggestive of coronary artery disease.
Abstract:
The purpose of the study to predict the coronary arterial disease by exercise treadmill scoring system and to see the correlation of angiographic extent of coronary artery disease by high treadmill score in our country. The present prospective study carried out in the department of cardiology, Bangabandhu Sheikh Mujib Medical University, University Cardiac Centre during the period of January 2006 to July 2006. Based on inclusion and exclusion criteria a total of 80 patient of chronic stable angina or chest pain evaluation having positive ETT who were admitted in university cardiac centre in Bangabandhu Sheikh Mujib Medical University and underwent coronary angiogram within one month were the study population. Among 80 subjects 60(75%) were male and 20(25%) were female and male: female ratio 3:1 Mean age of male subject 51.37±9.08 years and mean age of female subjects were 43.75±7.67 years. Three quarter of the subject had the history of typical anginal pain followed by 21.3% atypical and 3.8% pain of non-anginal origin. All the risk factors like, dyslipidemia (90%), HTN (68.8%) past smoker (45%), current smoker (32.5%), diabetes (36.3%), family history of coronary artery disease (25%) and sudden death of first degree relatives (8.8%); dyslipidemia was the highest percentage. Among 80 subjects more than one third 35% (28) of the subjects were observed to be normal by angiogram, 28.8% (23) had SVD, 16.3% (13) DVD and 20% (16) TVD. Approximately 70% of the significant stenosis was predicted as having high probability of 30.8% as intermediate probability and none as low probability with exercise test scores. Multi-vessel coronary artery disease were predicted by high probability exercise test score 82.8%. Thus high probability score needs urgent coronary angiogram.
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