Advanced

The Role of New Two Parameters to Improve Diagnostic Accuracy of Treadmill Exercise Test Detect Significant Coronary Artery Disease

Author : M.A. ffendy, G. R. Endamatriza, B. B. Tiksnadi, M. Akbar, A. Purnomowati, T. A. Aprami
Upload Date : 19-04-2018

Background : The new criteria of positivity of exercise stress testing for diagnostic methods to detect coronary artery disease (CAD) are the ST/HR Hysteresis and ST/HRindex. The study sought to analyze the relation between combining ST/HR Hysteresis and ST/HR index with the presence of significant CAD.

Method: We conducted a single center, retrospective descriptive analytic study in patients with positive ischemic response from exercise stress test, and had both parameters data. All patients should underwent coronary angiography in Hasan Sadikin Hospital within the period December 2015 to August 2017. The value of ST/HR hysteresis and ST/HR index was calculated automatically from stress test machine. Significant CAD was defined based on coronary angiography finding of stenotic lesions ≥ 70% at the major coronary arteries and/or ≥ 50% at the left main coronary artery.

Results: Of 90 enrolled patients meet inclusion criteria, 36 underwent coronary angiography. We identified 22 patients had significant CAD (PPV : 61.1%). The Mann-Whitney test revealed a significant difference ST/HR hysteresis between patients with significant CAD and those without (median 0,075 (0,022 – 0,380) vs 0,032 (0,001 – 0,177)), p-value <0,001) but not significant difference ST/HR index between patients with significant CAD and those without (median 0,91 (0,06 – 4,88) vs 0,71 (0,14 – 2,60)), p-value 0,620). Based on the receiver operating characteristic (ROC) analysis, ST/HR hysteresis >0,045 had area under curve (AUC) of 0,864, resulting in sensitivity of 95,2% and specificity of 71,4% (p <0,001). Combining ST/HR hysteresis and ST/HR index increasing specificity 5,5% (p<0,001). Conclusions: In patients with positive ischemic response in exercise stress test, the value of ST/HR hysteresis is associated with significant CAD but not with ST/HR index. Combining ST/HR hysteresis and ST/HR index could increase specificity to detect significant CAD.

KEYWORDS : Coronary artery disease, Exercise stress test, ST/HR hysteresis, ST/HR index


Save Item
Download
Similar Articles

Differences in Paraoxonase 1 (PON1) and Ox-LDL Serum Level in Coronary Artery Disease and Non Coronary Artery Disease Patients(R. Adriana, Y.H. Oktaviono, D. Soemantri)

The Relationship Between Fragmented QRS Complex and Coronary Artery Disease in Patient with Total Atrioventricular Nodal Block Requiring Permanent Pacemaker Implantation(M. Rusydi, Y. Yuniadi, S. B. Raharjo, D. Hanafy, D. Yugo)

Distributon of Multiple Vessels Coronary Artery Disease and Risk Factors in Patient with Acute Coronary Syndrome: Study From Sardjito General Hospital Registry(A. Pradhana, H.P. Bagaswoto, N. Taufiq, B.Y. Setianto)

Precordial ST Segment Depression on Admission Electrocardiogram as a Simple Noninvasive Tool for Predicting Coronary Artery Disease Complexity in Patients with Inferior Myocardial Infarction(J. Suganti, A. C. Lubis, A. A. Siregar, A. Sitepu, C. A. Andra, A. N. Nasution, H. Hasan)

The Associtaion between Uric Acid Level with Multivessel Coronary Artery Disease on Patients who Underwent Coronary Angiography in Abdul Wahab Syahranie General Hospital Samarinda(M.D.Pratama, D. Budiono, O.M.S Nasution, D. Herdianto)

Correlation of Lipid Profile with the Severity of Coronary Artery Disease(M.F. Rizky, P.C. Fianirazha, A.H. Rolando, M.W. Hadi, M.N. Afif, S.F. Liliana, S. Imran, U. Ferry )

Association Between Glycated Hemoglobin with Severity of Coronary Artery Disease in Non-Diabetic Patients(I.M Raditya, M. Syafri, M. Yanni)

Age, High Density Lipoprotein Cholesterol and Triglycerides are Correlated with Triple-Vessel Coronary Artery Disease(Y.S. Pratama, U. Bahrudin, S. Sungkar, I. Uddin)

Lipid Profile and It’s Association with Multivessel Coronary Artery Disease on Patients Who Underwent Coronary Angiography in Abdul Wahab Syahranie General Hospital Samarinda(D. Budiono, O.M.S Nasution, M.D.Pratama , D. Herdianto)

Association between Biomarkers and Plaque Vulnerability Detected by Optical Coherence Tomography in Patient with Coronary Artery Disease: a Meta-analysis(U. Bahrudin, R.A. Raharjo, S. Herminingsih, I. Uddin, Hardian, Y. Herry, S. Rifqi)

Copyrights © 2018 ASMIHA | Managed by Indonesia Medical Event (IME)