ABSTRACT
To find out the best combination of parameters; clinical and exercise induced hemodynamic and electrocardiographs, that could improve the diagnostic performance of exercise test. Exercise test and coronary angiography were performed for 112 patients with angina pectoris and normal electrocardiogram. The univariate predictors of the presence of CAD were aged >/= 40 years, male gender, hypertension, smoking, typicality of chest pain, development exertional chest pain, shorter exercise duration, decrease systolic blood pressure [BP] >/= 10 mmHg or systolic BP 3 min post-exercise >90% peak, heart rate drop <12 b/m one minute post exercise, exercise induced ST-segment depression >/= 1 mm, ST/HR slope >/= 2.4 microV/beat/minute, increased T amplitude >/= 2.5 mm, lengthening or no change of P wave duration, decrease or no change in Q wave depth, either R wave increase >/= 2mm or decrease >/= 1mm, QTD >60 ms, QTDc >70 ms, Q-X/QT ratio in V5 >0.5 and delta QTD rest to peak exercise >/= 16 mm and. Using multivariate logistic regression analysis we proved that using either ST depression >/= 1 mm or QTDc >70 ms as a positive exercise test significantly improved the sensitivity and the negative predictive value of the test without a significant decrease in the specificity. Using either ST depression >/= 1 mm or QTDc >70 ms as a positive exercise test improves the diagnostic performance of the test