ABSTRACT
This study was aimed to find out the accuracy of exercise test in patients with suspected coronary artery disease [CAD] presenting to Cardiology department, Lady Reading Hospital, Peshawar. In this retrospective study, records of all those patients with suspected CAD, who presented to Cardiology department, Lady Reading Hospital, Peshawar from July 2000 to July 2003, were analyzed. Only those patients who underwent both exercise tolerance test [ETT] and coronary angiography were included in the study. Exercise test was performed using standard Bruce protocol. Study population comprised of 664 patients, including 559 [84%] men and 105 [16%] women, with mean age of 50+9.7 [range 20-85] years. Coronary angiography showed 601/664 patients had stenosis of >70% in at least one coronary artery. Of these 601 patients 351[58.47%] had abnormal ETT, 105[17.47%] had negative ETT and 145[24.12%] had non-diagnostic ETT. After excluding the non-diagnostic results, the sensitivity was 76.97%. Among the 63/664 individuals with minimal or no coronary stenosis, 18[28.57%] had no ischemic ST changes during ETT, 21[33.33%] had positive ETT and 24[38.09%] had non-diagnostic ETT. Thus the specificity was 46.15%. Positive predictive value of ETT was 95% and negative predictive value was 15%. Overall accuracy of ETT was 55.50%. Exercise ECG testing has an important role in diagnosing suspected coronary artery disease. Patients with positive ETT should further be evaluated by coronary angiography. A negative ETT does not exclude CAD