| Comparison of computer ST criteria for diagnosis of severe coronary artery disease. | |
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MedLine Citation:
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PMID: 8094938 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To determine which computer ST criteria are superior for predicting patterns and severity of coronary artery disease during exercise testing, 230 male veterans were studied who had both coronary angiography and a treadmill exercise test. Significant (p < or = 0.05) differences in computer-scored ST criteria were observed among patients with progressively increasing disease severity. Three-vessel/left main disease produced responses significantly different from 1- and 2-vessel disease or those with < 70% occlusion. Discriminant function analysis revealed that horizontal or downsloping ST depression measured at the J junction during exercise or recovery, or both, was the most powerful predictor of severe disease. With use of a cut point of 0.075 mV ST depression, horizontal or downsloping ST depression alone yielded a sensitivity of 50% (95% confidence interval = 35 to 65%) and specificity of 71% for prediction of severe disease; the only additional variable that added significantly to the prediction was exercise capacity, which improved sensitivity to 57% (95% confidence interval = 41 to 72%) with no change in specificity. Measurements of ST amplitude at the J junction and at 60 ms after the J point without slope considered and other scores, including the Treadmill Exercise Score, ST Integral, and ST/heart rate index, had a lower but comparable predictive accuracy when compared with horizontal or downsloping ST depression. Prediction of coronary artery disease severity can be achieved using computerized electrocardiographic measurements obtained during exercise testing. The most powerful marker for severe coronary artery disease is the amount of horizontal or downsloping ST-segment depression during exercise or recovery, or both, a measurement that stimulates the traditional visual approach. |
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Authors:
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P M Ribisl; J Liu; I Mousa; W G Herbert; C P Miranda; J N Froning; V F Froelicher |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 71 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1993 Mar |
Date Detail:
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Created Date: 1993-03-19 Completed Date: 1993-03-19 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 546-51 Citation Subset: AIM; IM |
Affiliation:
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Cardiology Department, Long Beach Veterans Affairs Medical Center, California. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use Aged Computer Simulation Coronary Angiography Coronary Disease / diagnosis*, drug therapy, physiopathology Diagnosis, Computer-Assisted* Discriminant Analysis Electrocardiography* Exercise Test Hemodynamics / physiology Humans Male Middle Aged Models, Cardiovascular Predictive Value of Tests ROC Curve |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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