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- Karlsson, Jan-Erik, et al.
(author)
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Ambulatory ST-recording has no additional value to exercise test for identification of severe coronary lesions after an episode of unstable coronary artery disease in men
- 1993
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In: International Journal of Cardiac Imaging. - : Wolters Kluwer. - 0167-9899. ; 9:4, s. 281-289
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Journal article (peer-reviewed)abstract
- One month after an episode of unstable coronary artery disease, 95 male patients performed coronary angiography, 48 hours ambulatory ST-recording and also an exercise test. ST-depression occurred in 29.5% during the ST-recording and in 44.2% during the exercise test (p<0.05). In patients with ST-depression at ambulatory monitoring, 79% demonstrated the same finding at the exercise test. A high risk response at the exercise test - defined as either ST-depression in ≥ 3 leads, ST-depression in 1-2 leads with a maximal work load below the 60th percentile or a maximal work load below the 30th percentile regardless of the ECG reaction - occurred in 56.8%. Severe coronary lesions - defined as three vessel disease, left main stenosis or proximal left anterior descending artery stenosis as part of two vessel disease - was observed in 46.3%. Patents with a high risk exercise test response and patients with ST-depression during ST-recording had severe coronary lesions in 67% and 64% respectively. However, a high risk exercise test response occurred in 82%, while ST-depression at ambulatory monitoring was observed only in 41% of the patients with severe coronary lesions (p < 0.001). Thus, ambulatory ST-recording one month after an episode of unstable coronary artery disease in men adds no further information to a symptom limited exercise test in order to identify patients with severe coronary lesions.
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