ACCURACY OF TREADMILL EXERCISE ELECTROCARDIOGRAPHY IN DETECTING RESTENOSIS FOLLOWING SINGLE-VESSEL PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

To develop an improved method for diagnosing restenosis using treadmil l exercise electrocardiography (ECG) following percutaneous translumin al coronary angioplasty (PTCA), we prospectively evaluated 46 patients who underwent PTCA for the treatment of single-vessel coronary artery disease and who did not have a history of myocardial infarction. Trea dmill exercise ECG and coronary angiography were performed 3 months af ter PTCA to determine their accuracy in diagnosing restenosis based on standard ST-segment depression criteria, the difference between the m aximum ST-segment depression before and 3 months after PTCA (less than or equal to 0.5 mm: positive; > 0.5 mm: negative), and the difference between Sigma ST-segment depression before PTCA and 3 months after PT CA (less than or equal to 1.5 mm: positive; > 1.5 mm: negative), The s ensitivity, specificity, and diagnostic accuracy of standard ST-segmen t depression criteria were 65%, 66%, and 65%, respectively. The sensit ivity, specificity, and accuracy for the difference in maximum ST-segm ent depression were 77%, 76%, and 76%, respectively, whereas the value s for the difference in Sigma ST-segment depression were 77%, 83%, and 80%, respectively. Based on these results, we conclude that using the difference between ST-segment depression before and after PTCA improv es the accuracy of treadmill exercise ECG for diagnosing restenosis. ( C) 1997 by Excerpta Medica, Inc.