Document Detail

Population selection and performance of the exercise ECG for the identification of coronary artery disease.
MedLine Citation:
PMID:  8296696     Owner:  NLM     Status:  MEDLINE    
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)
P M Okin; P Kligfield
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  127     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-03-03     Completed Date:  1994-03-03     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  296-304     Citation Subset:  AIM; IM    
Department of Medicine, New York Hospital-Cornell Medical Center, NY 10021.
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MeSH Terms
Angina Pectoris / diagnosis,  physiopathology
Coronary Angiography
Coronary Disease / diagnosis*,  physiopathology
Exercise Test*
Heart Catheterization
Heart Rate / physiology
Hypertrophy, Left Ventricular / physiopathology
Middle Aged
Myocardial Infarction / physiopathology
ROC Curve
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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