POSITIVE PREDICTIVE VALUE OF EXERCISE TOLERANCE TEST IN PATIENTS; TAKING ANGIOGRAPHIC FINDINGS AS GOLD STANDARD

Abstract

Objective: To determine the accuracy of positive predictive value of Exercise Tolerance Test in patients; taking angiographic findings as gold standard.

Study Design: A descriptive cross-sectional study.

Place and Duration of Study: This study was conducted at outpatient department and coronary care units of Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi from January 2018 till June 2018.

Material and Methods: Patients between the ages of 35-75 years of both genders presenting with positive ETT undergoing angiography were included in the study using consecutive sampling. Patients with previous MI, PCI or CABG, smokers with >5 pack years and alcohol drinkers were excluded from the study. Patients fulfilling selection criteria were enrolled through OPD after the informed consent. Angiographic findings were noted and labelled positive with vessel disease present. All the data was entered and analysed using SPSS version 21.

Results: Total 140 patients were included for the study. There were 85 (60.7%) male patients and 55 (39.2%) females. Mean age of the patients was 40.3 ± 15.6 years. About 44 (31.4%) patients were diabetic, 53 (37.8%) overweight/obese and 2 5(17.8%) patients had family history of CAD. Mean duration of typical chest was reported to be 6.2 ± 0.5 months. All the patients were ETT positive and then underwent angiography. Out of all the ETT positive patients, 29 (27.6%) patients had single vessel disease, 31 (29.5%) double vessel disease and 60 (57.1%) patients had triple vessel disease on angiography. Positive predictive value of ETT was found to be 75%.

Conclusion: Our study results showed that exercise tolerance test has high positive predictive value. Thus ETT is recommended for the screening of coronary artery disease instead of going for angiography as coronary angiography is expensive procedure while ETT requires little intervention and expertise to diagnose coronary artery disease.
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