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

Günaydın, Zeki Yüksel; Bektaş, Osman; Gürel, Yusuf Emre; Karagöz, Ahmet; Kaya, Ahmet; Kırış, Tuncay; Zeren, Gönül; Yazıcı, Selçuk

doi:10.5603/kp.a2015.0143

Cited by 11 publications

(11 citation statements)

References 19 publications

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“…but the DTS was not a predictor of a high SYNTAX score according to the multivariate logistic regression analysis. There are several differences between our and the study of Günaydın et al [23] which may explain the discrepancy in results. For example, in contrast to Günaydın study, our study population was larger (406 vs. 267 patients in Günaydın study), we included patients at higher cardiovascular risk, such as those with PAD and chronic renal failure, and we excluded patients with normal coronary arteries and noncritical stenosis (≤50%).…”

Section: Discussioncontrasting

confidence: 95%

“…On the other hand, in a cohort of 258 patients with EST and coronary angiography, Dzenkeviciute et al [22] demonstrated a weak correlation (r = -0.173; p = 0.007) between the two scores. Günaydın et al [23] reported that the DTS was an independent predictor of a high SYNTAX score in 267 patients who underwent coronary angiography after a positive EST [23]. In our study, patients with a high SYNTAX score had a more negative DTS, FIGURE 1.…”

Section: Discussionsupporting

confidence: 50%

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Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease

Emren

Gediz

Şenöz

et al. 2019

Bosn J of Basic Med Sci

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An impaired heart rate recovery (HRR) has been associated with increased risk of cardiovascular events, cardiovascular, and all‐cause mortality. However, the diagnostic ability of HRR for the presence and severity of coronary artery disease (CAD) has not been clearly elucidated. Our aim was to investigate the relationship between HRR and the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score in patients with stable CAD (SCAD). A total of 406 patients with an abnormal treadmill exercise test and ≥50% coronary stenosis on coronary angiography were included. The HRR was calculated by subtracting the HR in the first minute of the recovery period from the maximum HR during exercise. The SYNTAX score ≥23 was accepted as high. Correlation of HRR with SYNTAX score and independent predictors of high SYNTAX score were determined. A high SYNTAX score was present in 172 (42%) patients. Mean HRR was lower in patients with a high SYNTAX score (9.8 ± 4.5 vs. 21.3 ± 9, p < 0.001). The SYNTAX score was negatively correlated with HRR (r: -0.580, p < 0.001). In multivariate logistic regression analysis, peripheral arterial disease (OR: 13.3; 95% CI: 3.120–34.520; p < 0.001), decreased HRR (OR: 0.780; 95% CI: 0.674–0.902; p = 0.001), peak systolic blood pressure (OR: 1.054; 95% CI: 1.023–1.087; p = 0.001), and peak HR (OR: 0.950; 95% CI: 0.923–0.977; p < 0.001) were found to be independent predictors of a high SYNTAX score. Our results showed that HRR is significantly correlated with the SYNTAX score, and a decreased HRR is an independent predictor of a high SYNTAX score in patients with SCAD.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionsupporting

confidence: 50%

Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease

Emren

Gediz

Şenöz

et al. 2019

Bosn J of Basic Med Sci

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“…Calculation of diagnostic values is done based on Chisquared table and obtained a sensitivity of 90%, specificity of 61%, negative predictive value of 91.6%, and positive predictive value of 60%. The results of this study have better sensitivity and specificity than studies conducted by Gunaydin et al 9 who assessed the DTS relationship with the severity of coronary artery disease assessed by Syntax and obtained AUC of 0.83 (IK 0.7-0.88) with sensitivity of 74 % and specificity of 73%. 4 The diagnostic value of DTS sensitivity obtained in this study is also better than the diagnostic value based on study conducted by Tamargo et al 15 , where high risk DTS (DTS <-11) has a sensitivity of 30.8%, specificity of 90.5%, for detecting coronary lesions severity.…”

Section: Discussioncontrasting

confidence: 53%

“…7 Duke Treadmill Score (DTS) has been shown to have a strong correlation with the complexity of coronary artery lesions assessed by Syntax. 8,9 However, DTS does not describe the role of risk factors for coronary heart disease in the complexity of coronary artery lesions, there is no data regarding the addition of risk factors for CHD in DTS diagnostic values in predicting the complexity of coronary artery lesions assessed based on Syntax.…”

Section: Introductionmentioning

confidence: 99%

Addition of Risk Factors of Coronary Heart Disease in Diagnostic Value of Treadmill Score for Detecting Complexity of Coronary Arterial Lesions

Nasution

Siregar

Hasan

et al. 2018

Acta Cardiol Indones

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Background: Coronary heart disease (CHD) is still the leading cause of death in the world. There are various risk factors for atherosclerosis leading to CHD. Duke Treadmill Score (DTS) is known to demonstrate prognostic stratification and has a diagnostic value in predicting the number of coronary arteries involved in patient populations with ischemic heart disease. However, DTS does not describe the role of risk factors for coronary heart disease to the complexity of coronary artery lesions. This study aims to add risk factors for coronary heart disease on DTS to detect the complexity of coronary artery lesions with stable angina pectoris.Methods: This study was a cross-sectional study in stable angina pectoris patient who comes to Haji Adam Malik Hospital Medan from January 2017 until February 2018. Patients who have done treadmill test and coronary angiography, and fulfill inclusion and exclusion criteria are included in the study. ECG examination and recording of risk factors for coronary heart disease were done. DTS assessment was performed based on a treadmill test and Syntax score based on coronary angiography results. Diagnostic tests were performed to assess the sensitivity and specificity of the addition of CHD risk factors to detect the complexity of coronary artery lesions.Results: Of the 76 people with stable angina pectoris, 55 people were found with low SYNTAX and 21 people with high Syntax. DTS is divided into 3 groups: mild (> -10), moderate (-10 to - 13.5), and severe (≤-13.6) based on the cut off of the ROC curve. Risk factors for CHD are divided into 3 groups, mild (≤3 CHD risk factors), moderate (4-6 CHD risk factors), and severe (7 CHD risk factors) based on the cut off of the ROC curve, then assessed the relationship with Syntax which has been divided into 2 groups, low Syntax, and high Syntax. Diagnostic test shows the addition of risk factors of CHD to DTS to detect the complexity of coronary artery lesions have greater sensitivity and specificity than DTS without the addition of risk factors of CHD, 95%, and 89%.Conclusion: The addition of risk factors for coronary heart disease on DTS can detect the complexity of coronary artery lesions.

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“…There have been many studies in this field, and the diagnostic and prognostic value of DTS is quite well defined [2][3][4][5][6][7][8][9]. However, a possible limitation of earlier studies is that the results were obtained before the use of current medical therapies that significantly improve patient outcomes, such as statin therapy to appropriate low-density lipoprotein cholesterol (LDL-C) goals and perhaps lower blood pressure (BP) goals [10].…”

Section: Introductionmentioning

confidence: 99%

Value of Duke treadmill score in predicting coronary artery lesion and the need for revascularisation

Dženkevičiūtė

Šapoka²,

Kasiulevičius³

et al. 2017

Kardiol Pol

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A b s t r a c tBackground: Exercise electrocardiography is a long-standing method for the evaluation of coronary artery disease (CAD), and it remains the initial test for most patients who can exercise adequately with a baseline interpretable electrocardiogram. However, there is little information about the relationship between Duke treadmill test score (DTS) and severity of coronary artery lesion, as well as estimating the need for revascularisation. Aim:The aim of the study was to ascertain whether the DTS could be an efficient parameter in choosing coronary revascularisation in different DTS groups. Methods:Two hundred and fifty-eight (n = 258) patients had positive exercise testing for CAD and underwent coronary angiography. The patients were divided into three groups according to the DTS: low-risk (with a score of ≥ +5), moderate-risk (with scores ranging from -10 to +4), and high-risk (with a score of ≤ -11). Coronary angiography was done by the Judkins technique. A coronary lesion was considered significant when stenosis of the coronary artery was ≥ 70% and stenosis of the trunk was ≥ 50%. The SYNTAX score was determined. Results:The study group included 258 patients with mean age 62.66 ± 9.6 years, and most of them were men (72.8%). Patients with high-and intermediate-risk DTS had the same SYNTAX score (16.35 ± 7.3, 15.09 ± 10.08 and 11.80 ± 9.88, respectively; p = 0.064) compared to low-risk DTS. A negative correlation between DTS and significant coronary artery stenosis (r = -0.181; p = 0.005), SYNTAX score (r = -0.173; p = 0.007), and cardiac revascularisations (r = -0.213; p = 0.001) were found. In multiple linear regressions to predict coronary revascularisation the SYNTAX score (B = 0.018; p = 0.0001), DTS (B = -0.014, p = 0.008) and previous myocardial infarction (B = -0.143; p = 0.047) were significant predictors. Conclusions:The DTS alone is a useful tool in suspecting a significant coronary artery stenosis, but it is not accurate enough for revascularisation. Thus, by adding clinical information, its value may be maximised.

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

Cited by 11 publications

References 19 publications

Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease

Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease

Addition of Risk Factors of Coronary Heart Disease in Diagnostic Value of Treadmill Score for Detecting Complexity of Coronary Arterial Lesions

Value of Duke treadmill score in predicting coronary artery lesion and the need for revascularisation

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