Document Detail

Diagnostic and prognostic value of Holter-detected ST-segment deviation in unselected patients with chest pain referred for coronary angiography: a long-term follow-up analysis.
MedLine Citation:
PMID:  11555517     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the diagnostic and prognostic significance of ST-segment deviation detected by ambulatory Holter monitoring in unselected chest pain patients referred for coronary angiography. METHODS: Two hundred seventy-seven patients (71% were men) who underwent coronary angiography for evaluation of chest pain were studied with 24-h ambulatory Holter monitoring within 72 h of angiography. A lumen diameter reduction of > or = 50% was considered coronary artery disease. The ST-segment deviation was defined as > or = 1-mm deviation from the baseline lasting > or = 1 min separated by a minimum of 1 min. The patients were followed up for 65 +/- 21 months (mean +/- SD) for occurrences of death, myocardial infarction, hospitalization for unstable angina, and need for revascularization. RESULTS: Of the 277 patients, 223 (80%) had coronary artery disease. The prevalence of coronary artery disease was not significantly different in patients with (43 of 48 patients; 90%) and without (180 of 229 patients; 79%) Holter-detected ST-segment deviation. The diagnostic accuracy of Holter-detected ST-segment deviation in predicting the presence of coronary artery disease was poor (33%), with a sensitivity of 19% and a specificity of 91%. The presence of Holter-detected ST-segment deviation was not predictive of future cardiac events or death. CONCLUSION: The ST-segment changes detected on ambulatory Holter monitoring are of limited value in identifying coronary artery disease and predicting the future adverse cardiac events or death in unselected patients with chest pain.
C K Nair; I A Khan; D J Esterbrooks; K L Ryschon; D E Hilleman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  120     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-13     Completed Date:  2001-10-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  834-9     Citation Subset:  AIM; IM    
Division of Cardiology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68131, USA.
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MeSH Terms
Aged, 80 and over
Angina Pectoris / diagnosis*,  radiography
Electrocardiography, Ambulatory*
Follow-Up Studies
Middle Aged
Prospective Studies
Sensitivity and Specificity

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