ABSTRACT
Systolic blood pressure recovery [rSBP] immediately after exercise effectively predicts survival and co-morbidity in those with atherosclerotic heart disease. The aim of this study was to evaluate the diagnostic value of the rSBP index for detecting coronary artery disease [CAD] severity. Prospective cross-sectional study Shafa Hospital, Kerman Province, Iran between March and August 2009 Ninety-four consecutive adult patients who were candidates for evaluation of CAD Interventions: Exercise stress testing and initial coronary angiography Main Outcome Measures: The rSBP was calculated by dividing the SBP three minutes after exercise by the SBP at peak exercise. Subjects with a high ratio of SBPs at 3 min of recovery to peak exercise were more likely to have severe CAD, adjusting for age, gender and body mass index using multivariate logistic regression analysis. The sensitivity, specificity, positive predictive value and negative predictive value of abnormal rSBP for predicting severe CAD were 42.6%, 81.8%, 50.0% and 77.1%, respectively. According to the ROC curve analysis, the rSBP measurement was a good indicator of severe CAD with areas under the ROC curves 0.652 [95% CI: 0.524 - 0.780]. The optimal cut-off value for rSBP for predicting severe CAD was identified at 0.78 yielding a sensitivity of 60.7% and a specificity of 65.2%. Systolic blood pressure ratio at three minutes post-exercise is a good diagnostic marker for predicting severe CAD with a high specificity and a good discriminative power