Predictive value of a positive exercise stress testing and correlations with cardiovascular risk factors

Electrocardiogram exercise stress test (EST) is a widespread technique in assessment of coronary artery disease, stratifying cardiovascular risk and prognosis.

Evaluation of the impact of cardiovascular risk factors upon the results of EST.

The 2-year retrospective study included 294 patients referred to an EST. All patients were assessed according to: presence of typical angina chest pain at admission, medical history of angina or myocardial infarction, resting electrocardiogram, global ejection fraction at echocardiographic exam and traditional cardiovascular risk factors. We compared the results between two groups: positive and negative EST.

The patients were age- and sex-matched. 160 patients (54.42%) had a positive EST. Positive EST was associated with typical angina chest pain at admission (88.12% vs. 76.11%, p = 0.008), coronary artery disease history (61.87% vs. 41.04%, p = 0.0003), resting ECG abnormalities (49.37% vs. 36.56%, p = 0.026), arterial hypertension (85.62% vs. 74.62%, p = 0.019). Ejection fraction was higher in the negative EST group (63.34 +/- 8.57% vs. 61.18 +/- 11.34%, p = 0.035). Type 2 diabetes mellitus, smoking, obesity, dyslipidemia and inflammatory syndrome did not significantly influence the results of the EST.

Typical angina, medical history of coronary artery disease, arterial hypertension, and reduced ejection fraction are strong predictors for a positive exercise stress test.