Exercise Capacity Based Prediction of Multi-Vessel Disease from Exercise Treadmill Test (ETT) and Correlation of the Findings with Coronary Angiography (CAG)

Abstract

Background: Stress testing is frequently used for a preliminary evaluation of individuals with suspected coronary artery disease, acting as a prognosis for cardiac catheterization and provides a clear indication of the condition of the coronary arteries, and further action can be taken considering that information

Objective: To determine the patients’ exercise capacity that could predict the presence of multivessel disease.

Methods: A retrospective cohort study of 70 patients at Shalamar Hospital, Lahore analyzed Exercise tolerance test (ETT) and Coronary angiography (CAG) data. Patients with stable angina, normal baseline ECG, and between 30-60 years were included, excluding those with CAD, limited mobility, or lung pathology.

Results: The study involved 70 patients who underwent ETT followed by CAG. Out of them, 59(84.3%) were males 48(68.6%) have coronary artery disease (CAD), 21 (43.8%) having SVD and 27(54.2%) having MVD. Hypertension (HTN) was observed in 28(58.3%), Diabetes mellites in 27(56.2%), Family History of heart disease was recorded in 7 (14.6%), 12(25%) were smokers and Coronary Calcium was observed in 9(18.8%) patients. No statistical association between METs and MVD (p=0.2). Unit increase in duke treadmill score reduces the chances of multivessel disease 0.159 times (r=0.159). There was moderate correlation between vessels involved and duke treadmill score (r= -.752).

Conclusion: Duke Treadmill Score (DTS) reveals a significant difference in obstructive CAD prevalence among low, middle, and high-risk categories, predicting CAD severity and MVD. Patients in intermediate and severe DTS should only be referred for CAG to avoid unnecessary invasive catheterization and improve medical management.