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Use of a prognostic treadmill score in identifying diagnostic coronary disease subgroups.

Publication ,  Journal Article
Shaw, LJ; Peterson, ED; Shaw, LK; Kesler, KL; DeLong, ER; Harrell, FE; Muhlbaier, LH; Mark, DB
Published in: Circulation
October 20, 1998

BACKGROUND: Exercise testing is useful in the assessment of symptomatic patients for diagnosis of significant or extensive coronary disease and to predict their future risk of cardiac events. The Duke treadmill score (DTS) is a composite index that was designed to provide survival estimates based on results from the exercise test, including ST-segment depression, chest pain, and exercise duration. However, its usefulness for providing diagnostic estimates has yet to be determined. METHODS AND RESULTS: A logistic regression model was used to predict significant (>/=75% stenosis) and severe (3-vessel or left main) coronary artery disease, and a Cox regression analysis was used to predict cardiac survival. After adjustment for baseline clinical risk, the DTS was effectively diagnostic for significant (P<0.0001) and severe (P<0.0001) coronary artery disease. For low-risk patients (score >/=+5), 60% had no coronary stenosis >/=75% and 16% had single-vessel >/=75% stenosis. By comparison, 74% of high-risk patients (score <-11) had 3-vessel or left main coronary disease. Five-year mortality was 3%, 10%, and 35% for low-, moderate-, and high-risk DTS groups (P<0.0001). CONCLUSIONS: The composite DTS provides accurate diagnostic and prognostic information for the evaluation of symptomatic patients evaluated for clinically suspected ischemic heart disease.

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Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

October 20, 1998

Volume

98

Issue

16

Start / End Page

1622 / 1630

Location

United States

Related Subject Headings

  • Survival Rate
  • Risk Factors
  • Regression Analysis
  • ROC Curve
  • Prognosis
  • Predictive Value of Tests
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
 

Citation

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Shaw, L. J., Peterson, E. D., Shaw, L. K., Kesler, K. L., DeLong, E. R., Harrell, F. E., … Mark, D. B. (1998). Use of a prognostic treadmill score in identifying diagnostic coronary disease subgroups. Circulation, 98(16), 1622–1630. https://doi.org/10.1161/01.cir.98.16.1622
Shaw, L. J., E. D. Peterson, L. K. Shaw, K. L. Kesler, E. R. DeLong, F. E. Harrell, L. H. Muhlbaier, and D. B. Mark. “Use of a prognostic treadmill score in identifying diagnostic coronary disease subgroups.Circulation 98, no. 16 (October 20, 1998): 1622–30. https://doi.org/10.1161/01.cir.98.16.1622.
Shaw LJ, Peterson ED, Shaw LK, Kesler KL, DeLong ER, Harrell FE, et al. Use of a prognostic treadmill score in identifying diagnostic coronary disease subgroups. Circulation. 1998 Oct 20;98(16):1622–30.
Shaw, L. J., et al. “Use of a prognostic treadmill score in identifying diagnostic coronary disease subgroups.Circulation, vol. 98, no. 16, Oct. 1998, pp. 1622–30. Pubmed, doi:10.1161/01.cir.98.16.1622.
Shaw LJ, Peterson ED, Shaw LK, Kesler KL, DeLong ER, Harrell FE, Muhlbaier LH, Mark DB. Use of a prognostic treadmill score in identifying diagnostic coronary disease subgroups. Circulation. 1998 Oct 20;98(16):1622–1630.

Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

October 20, 1998

Volume

98

Issue

16

Start / End Page

1622 / 1630

Location

United States

Related Subject Headings

  • Survival Rate
  • Risk Factors
  • Regression Analysis
  • ROC Curve
  • Prognosis
  • Predictive Value of Tests
  • Middle Aged
  • Male
  • Logistic Models
  • Humans