P-125 Correlation of Duke Treadmill Score with Gated SPECT-MPI (Myocardial Perfusion Imaging) in Patients Referred for Chest Pain Evaluation

Shaikh, Ayaz Hussain; Malik, Farah; Hanif, Bashir; Hassan, Khursheed; Amin, Adnan; Siddiqui, Shamim

doi:10.1016/s1875-4570(09)60317-x

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“…Therefore, they suggested that the patients with low DTS do not need an MPI study and should undergo CAG for further evaluation [21]. In another similar study, it was hypothesised that patients with low DTS can be referred to CAG without SPECT-MPI and patients with high DTS can be followed on medical management [22]. Similarly, our study revealed that patients with DTS < -11.2 may have a high SS and should undergo CAG.…”

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confidence: 50%

The value of the Duke treadmill score in predicting the presence and severity of coronary artery disease

et al. 2016

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Section: Discussionsupporting

confidence: 50%

The value of the Duke treadmill score in predicting the presence and severity of coronary artery disease

et al. 2016

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“…9 They hypothesized that patients with high DTS can be referred for invasive coronary angiography without functional assessment. 9 In this issue of the journal, Joao et al investigate the survival analysis in a great number of patients (N = 310) with both high DTS and exercise stress MPS. Nearly one-third of the patients (90/310) with high DTS showed normal MPS and low hard event rates.…”

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confidence: 99%

Clinical value of high duke treadmill score with myocardial perfusion SPECT

Matsumoto

Hirayama

2016

Journal of Nuclear Cardiology

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Duke treadmill score (DTS) is well recognized as a simple prognostic score in patients with suspected coronary artery disease (CAD).1,2 It is positioned as a valid clinical tool when clinicians need to make a decision about the catheterization of patients with suspected CAD. It is calculated as follows, exercise duration (minutes) -(5 9 ST-segment deviation (millimeters) -(4 9 angina index (0 for no angina, 1 for angina, and 2 for exercise-limiting angina) and categorized as follows, low risk; \.5%/year, intermediate risk;.5% to 5%/year and high risk; [5%/year of cardiovascular events with a 4-year follow-up. Clinically, if patient achieved more than 10-minute duration of exercise without chest pain, 1 mm of ST depression on electrocardiogram (ECG) is permissible in terms of a conservative therapy. Shaw et al documented the incremental diagnostic value of DTS using ROC analysis to predict the presence of significant CAD (C75% stenosis) or severe CAD (3-vessel CAD or C75% left main disease).3 They showed the cardiac event rates for low-, moderate-, and high-risk grouping of DTS, annual cardiac death rates were .6%, 2%, and 7%, respectively, which were close to those in the original DTS. In that manuscript, they mentioned the limited sensitivity and specificity of the treadmill test for the detection of CAD may cause an increase of noninvasive stress imaging. 3,4 Previously, Hachamovitch et al also reported that stress myocardial perfusion single-photon emission computed tomography (MPS) adds an incremental prognostic value to DTS for the prediction of hard cardiac events. 5However, the expensive medical costs of stress imaging, which may add diagnostic accuracy to DTS, would be prohibitive. Therefore, the concordance and discordance between stress exercise test and noninvasive imaging should be discussed.A previous report showed that about 55% to 69% of patients with known or suspected CAD were classified as moderate risk by DTS. 3,6 Basically, the patients categorized as intermediate risk by DTS would be good candidates for stress MPS, the majority of the intermediate risk group may derive the maximum benefit for the differentiation of invasive catheter imaging in accordance with Bayes' theorem. 7,8 The higher sensitivity and specificity of stress MPS over that of the exercise test may reduce the unnecessary invasive imaging. 6The relationship between high DTS and stress MPS was evaluated by Shaikh et al in a small population (N = 13) in 2011. They showed that all the subjects with high DTS had high-risk MPS.9 They hypothesized that patients with high DTS can be referred for invasive coronary angiography without functional assessment. 9In this issue of the journal, Joao et al investigate the survival analysis in a great number of patients (N = 310) with both high DTS and exercise stress MPS. Nearly one-third of the patients (90/310) with high DTS showed normal MPS and low hard event rates. They found about 1.34%/year of cardiovascular death in the abnormal MPS group vs 0%/year of cardiovascular death in the norm...

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P-125 Correlation of Duke Treadmill Score with Gated SPECT-MPI (Myocardial Perfusion Imaging) in Patients Referred for Chest Pain Evaluation

Cited by 2 publications

References 0 publications

The value of the Duke treadmill score in predicting the presence and severity of coronary artery disease

The value of the Duke treadmill score in predicting the presence and severity of coronary artery disease

Clinical value of high duke treadmill score with myocardial perfusion SPECT

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