| Population selection and performance of the exercise ECG for the identification of coronary artery disease. | |
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MedLine Citation:
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PMID: 8296696 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To quantify the effect of population selection on the performance of exercise ECG criteria for the detection of coronary artery disease, the exercise ECGs of 212 clinically normal nonvolunteer subjects, 31 patients with no significant coronary disease at angiography, 153 patients with clinically stable angina, and 184 patients with catheterization-proved coronary disease were examined. Test specificity was examined separately in clinically normal subjects and in patients with angiographically normal coronary arteries, and test sensitivity was determined separately in patients with stable angina and those with catheterization-proved disease. Definition and selection of normal and abnormal study populations had marked effects on test performance. Standard ECG criteria, a simple ST depression magnitude partition of 150 microV, an ST segment/heart rate (ST/HR) index partition of 1.60 microV/beat/min, and an ST/HR slope partition of 2.40 microV/beat/min, identified coronary disease with comparably high specificities (94% to 97%) in clinically normal subjects, but with significantly lower specificities (68% to 77%, p = 0.002 to 0.0001) in patients with angiographically normal coronary arteries. Although sensitivity was significantly lower in patients with stable angina than in patients with catheterization-proved coronary disease for standard criteria (54% vs 70%, p = 0.004) and for the ST/HR index (88% vs 95%, p = 0.04), there was no significant difference in the poor sensitivity of the simple ST depression magnitude criteria (51% vs 58%) or in the high sensitivity of the ST/HR slope (93% vs 96%) in these abnormal patient groups.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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P M Okin; P Kligfield |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 127 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1994 Feb |
Date Detail:
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Created Date: 1994-03-03 Completed Date: 1994-03-03 Revised Date: 2006-02-27 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 296-304 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, New York Hospital-Cornell Medical Center, NY 10021. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angina Pectoris
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diagnosis,
physiopathology Coronary Angiography Coronary Disease / diagnosis*, physiopathology Electrocardiography* Exercise Test* Female Heart Catheterization Heart Rate / physiology Humans Hypertrophy, Left Ventricular / physiopathology Male Middle Aged Myocardial Infarction / physiopathology Patients* ROC Curve Sensitivity and Specificity |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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