Document Detail

Screening for the detection of coronary artery disease by using the exercise tolerance test in a preventive medicine population.
MedLine Citation:
PMID:  1790029     Owner:  NLM     Status:  MEDLINE    
We designed this study to identify patients with coronary artery disease (CAD), employing the exercise tolerance test, and to develop further criteria for ordering the exercise tolerance test in the preventive medicine population of the Cleveland Clinic Foundation. During 1987-1988 1,930 patients not known to have CAD were referred from the Department of Preventive Medicine for exercise tolerance tests as part of their periodic physical exams. We hypothesized that age was a major risk factor and ordered most (86.4%) tests on this basis: at age 40 and every two years after age 50. Twenty-five cases of CAD (25/1,930 or 1.3%) were found. One of 297 women was found to have CAD (0.3%). Seventeen patients were treated surgically and eight medically. Using age as an indication for testing detected 23 of 25 cases (92%). We compared the group with normal or nondiagnostic exercise tolerance tests and presumed not to have CAD (1,905 patients, median age 48) with the group with CAD (25 patients, median age 59). Age greater than 40, a total cholesterol level over 240 mg/dL, triglyceride level over 250 mg/dL, a total cholesterol to high-density lipoprotein ratio greater than 4.5, and a history of chest pain of any type were all significantly related to the presence of CAD. Testing men older than forty with two or more CAD risk factors, as has been recommended, would have resulted in finding five of the 25 cases (20%). Testing only patients who complained of any type of chest discomfort would have resulted in detecting 14 of the 25 cases (56%).(ABSTRACT TRUNCATED AT 250 WORDS)
R L Dunn; R N Matzen; S VanderBrug-Medendorp
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of preventive medicine     Volume:  7     ISSN:  0749-3797     ISO Abbreviation:  Am J Prev Med     Publication Date:    1991 Sep-Oct
Date Detail:
Created Date:  1992-03-27     Completed Date:  1992-03-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8704773     Medline TA:  Am J Prev Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  255-62     Citation Subset:  IM    
Department of Preventive Medicine, Cleveland Clinic Foundation, OH 44195.
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MeSH Terms
Age Factors
Coronary Disease / epidemiology,  prevention & control*
Decision Trees
Evaluation Studies as Topic
Exercise Test / standards*
Mass Screening / methods,  standards*
Middle Aged
Ohio / epidemiology
Preventive Health Services / standards*
Prospective Studies
Risk Factors
Erratum In:
Am J Prev Med 1992 Mar-Apr;8(2):133

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

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