Tools to improve the diagnostic accuracy of exercise electrocardiograms in patients with atypical angina pectoris

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dc.authorscopusid55317577700
dc.authorscopusid16315021800
dc.authorscopusid6505680586
dc.authorscopusid7005837198
dc.authorwosidAlpsoy, Seref/Z-1808-2018
dc.contributor.authorÖzkaramanlı Gür, Demet
dc.contributor.authorAkyüz, Aydın
dc.contributor.authorAlpsoy, Şeref
dc.contributor.authorGüler, Niyazi
dc.date.accessioned2022-05-11T14:40:09Z
dc.date.available2022-05-11T14:40:09Z
dc.date.issued2018
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.description.abstractObjective: Although frequently utilized, an exercise electrocardiogram (ECG) provides limited diagnostic accuracy in patients with atypical angina pectoris. The purpose of this study was to determine the possible incremental value of pretest probability (PTP) scores and exercise parameters in discriminating coronary artery disease (CAD) and to identify PTP cutoff values. Methods: In a retrospective cohort of 207 patients with atypical angina (76 women, 131 men; mean age: 57.6 +/- 8.2 years) who underwent coronary angiography (CAG) after a positive exercise ECG, the PTP was calculated according to the CAD Consortium basic and clinical models along with exercise parameters of blood pressure (BP), heart rate (HR), exercise duration, maximal metabolic equivalents (METs), HR reserve, HR recovery, chronotropic index, BP reserve, BP recovery, and ST/HR ratio. Patients were categorized into true positive (TP) or false positive (FP) groups, depending on the ultimate determination of a presence of obstructive CAD. Results: A TP result was associated with older age, male gender, hypertension, diabetes, hyperlipidemia, and higher basic and clinical PTP, as well as higher maximal BP, maximal ST deviation and ST/HR, but lower maximal METs, chronotropic index, and HR recovery. The basic and clinical PTP, and the chronotropic index could predict a TP test result irrespective of gender. Logistic regression analysis revealed that clinical PTP was the only independent predictor of TP results. A cutoff score of 18 for the basic and 21 for the clinical PTP were determined to discriminate CAD. Conclusion: This study has shown that, among various electrocardiographic and hemodynamic parameters, the clinical PTP and the chronotropic index are the most helpful tools to discriminate patients with CAD among patients with atypical angina.
dc.identifier.doi10.5543/tkda.2018.34358
dc.identifier.endpage384
dc.identifier.issn1016-5169
dc.identifier.issue5en_US
dc.identifier.pmid30024394
dc.identifier.scopus2-s2.0-85049916381
dc.identifier.scopusqualityQ4
dc.identifier.startpage375
dc.identifier.urihttps://doi.org/10.5543/tkda.2018.34358
dc.identifier.urihttps://hdl.handle.net/20.500.11776/8884
dc.identifier.volume46
dc.identifier.wosWOS:000446494100022
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorÖzkaramanlı Gür, Demet
dc.institutionauthorAkyüz, Aydın
dc.institutionauthorAlpsoy, Şeref
dc.institutionauthorGüler, Niyazi
dc.language.isoen
dc.publisherAves
dc.relation.ispartofTurk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology
dc.relation.publicationcategoryDiğeren_US
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCoronary artery disease
dc.subjectexercise electrocardiogram
dc.subjectpretest probability
dc.subjectCoronary-Artery-Disease
dc.subjectGuidelines
dc.subjectManagement
dc.subjectUpdate
dc.subjectProbability
dc.subjectPredictor
dc.subjectScore
dc.titleTools to improve the diagnostic accuracy of exercise electrocardiograms in patients with atypical angina pectoris
dc.title.alternativeAtipik angina pektorisi olan hastalarda efor testinin tanısal doğruluğunu arttıracak araçlar]
dc.typeEditorial

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