Angiographic correlates of the high-risk criteria for exercise testing andthe Duke Treadmill Score

Objective. To compare the sensitivity, the specificity, the positive and ne gative predictive value and the predictive accuracy of the Duke Treadmill S core, the Spanish Society of Cardiology (SEC) and American College of Cardi ology/American Heart Association (ACC/AHA) highrisk criteria for exercise t esting in the detection of left main disease, three vessel disease and two vessel disease involving the proximal left anterior descending artery. Patients and method. A cohort of 199 patients (age less than or equal to 75 years) consecutively admitted to hospital for unstable angina was studied. All patients underwent an exercise stress test and coronariography. Results. The SEC high-risk Criteria showed a sensitivity of 69.2% and a spe cificity of 49.0%. The ACC/AHA high-risk Criteria demonstrated a sensitivit y of 98.1% and a specificity of 23.8% and the Duke Treadmill Score presente d a sensitivity of 30.8% and a specificity of 90.5%. In patients with moder ate risk in the Duke Treadmill Score we found a sensitivity of 62.9% and a specificity of 39.8% for the SEC high-risk criteria, while the ACC/AHA high risk Criteria presented a sensitivity of 100.0% and a specificity of 5.8%. Conclusions. The ACC/AHA high-risk Criteria showed a higher sensitivity whi le the Duke Treadmill Score presented a higher specificity for the detectio n of left main disease, three vessel disease and two vessel disease involvi ng the proximal left anterior descending artery. The ACC/AHA and SEC high-r isk Criteria were found to be very useful in the group of patients with mod erate risk in the Duke Treadmill Score.