A comparative study on treadmill exercise test and coronary angiography in the diagnosis of coronary artery disease: report of 267 cases

AIM:To explore the related factors of influence on treadmill exercise test (TET), and in order to improve the accuracy in diagnosis of coronary artery disease (CAD). METHODS: 267 patients with suspected CAD were involved in this study, and underwent TET and coronary artery angiography (CAG), respectively.With CAG as the gold standard and the diagnostic results were compared to get the sensitiving and specificity of TET and the clinical factors influencing the outcomes of TET by statiseical analysis. RESULTS: The sensitivity, speci-ficity, false positive and false negative in diagnosis of CAD with TET were 64.7% (121/187), 52.5% (42/80), 47.5% (38/80) and 35.3% (66/187), respectively. The results showed the patients with typical angina, history of diabetes, ST-segment depression 0.2 mV and occurrence of typical angina induced by exercise had a higher true positive rate than the other ones. False positive rate was higher than true positive one in the changes of ST-segment in leads Ⅱ, Ⅲ, aVF. All cases with injury-induced ST-segment elevation were positive in TET. CONCLUSION: When combined with dangerous factors of CAD, the degree and form of ST-segment changes, and when the factors of influence on TET are eliminated, TET can increase the diagnostic specificity and accuracy of CAD.