The Value of Chest Pain during the Exercise Tolerance Test in Predicting Coronary Artery Disease

Abstract

The predictive power of 10 common exercise test parameters compared with coronary angiography was studied. Only the exercise electrocardiogram (EXECG), maximal rate pressure product (MAXRPP), and exercise chest pain (EXCP) contributed unique predictive information with the emergence of two interactions involving EXCP (EXCP•EXECG and EXCP· MAXRPP). In conclusion: (1) EXCP appears to be a more serious finding only in those higher risk individuals with either a positive EXECG or lower MAXRPP; (2) EXCP and its interactions may help discriminate between anginal and nonanginal, exertional chest pain, and (3) the contradictory results found when EXCP was allowed to interact may explain conflicting results in previous multivariate models regarding the predictive significance of EXCP.

The Value of Ten Common Exercise Tolerance Test Measures in Predicting Coronary Disease in Symptomatic Females

“…We have previously shown the importance of considering the inter active effects of predictor variables in a similar study with males [27]. In the present study, although numerous twoway interactions were apparent, none significantly im proved upon the existing model.…”

North of England evidence based guidelines development project: summary version of evidence based guideline for the primary care management of stable angina

“…Exercise testing is of value in patients with coronary artery disease to establish a prognosis and provide information in addition to that from invasive testing (II) 13 14 15 16. When interpreting an exercise test result it is important to take into account not just ST segment changes but other changes, such as duration of exercise, presence of pain, change in blood pressure, and change in heart rate (II) 17 18 19 20 21 22. However, the diagnostic usefulness of an exercise test is low in patients with a low pretest probability of coronary artery disease (II) 23 24…”