W. Desmet et al., LIMITED VALUE OF EXERCISE TESTING IN THE DETECTION OF SILENT RESTENOSIS AFTER SUCCESSFUL CORONARY ANGIOPLASTY, The American heart journal, 129(3), 1995, pp. 452-459
We studied the diagnostic value of exercise electrocardiographic (EGG)
testing in 191 patients who were completely asymptomatic 6 months aft
er a successful percutaneous transluminal coronary angioplasty procedu
re. With >70%- and >50%-diameter stenosis at follow-up as restenosis c
riteria, the sensitivities of exercise ECG testing were 29% and 21%; t
he specificities 89% and 91%; the positive predictive values 20% and 5
2%; the negative predictive values 93% and 70%; the accuracies 83% and
68%; and the risk ratios 2.8 and 1.7, for prevalences of 9% and 33%,
respectively. There were no significant differences in the diagnostic
value of exercise ECG testing between men and women, patients receivin
g or not receiving beta-blocking agents, and the presence or absence o
f pathologic Q waves. Significant differences in systolic blood pressu
re and the rate-pressure product at peak exercise were found between p
atients with and without restenosis. For individual patients, however,
no practical conclusions can be drawn from these values. In conclusio
n, the diagnostic value of exercise ECG testing for silent restenosis
is low, and supplementation with other techniques seems to be warrante
d.