EXERCISE STRESS-TESTING - CORRELATIONS AMONG HISTORY OF ANGINA, ST-SEGMENT RESPONSE AND PREVALENCE OF CORONARY-ARTERY DISEASE IN THE CORONARY-ARTERY SURGERY STUDY (CASS)
EXERCISE STRESS-TESTING - CORRELATIONS AMONG HISTORY OF ANGINA, ST-SEGMENT RESPONSE AND PREVALENCE OF CORONARY-ARTERY DISEASE IN THE CORONARY-ARTERY SURGERY STUDY (CASS)
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DOI：
10.1056/nejm197908023010502
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发表时间：
1979-01-01
影响因子：
158.5
通讯作者：
FISHER, LD
中科院分区：
文献类型：
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作者：
WEINER, DA;RYAN, TJ;FISHER, LD
为了确定负荷试验的诊断准确性在多大程度上受到冠状动脉疾病患病率的影响，对来自多中心临床试验的1465名男性和580名女性的胸痛描述、负荷试验结果和冠状动脉造影结果进行了相关分析。根据性别和胸痛的分类，测试前的风险（冠状动脉疾病的患病率）从7-87%不等。积极的压力测试只增加了6- 20%的测试前风险，但消极的测试只降低了2- 28%的风险。虽然假阳性结果的百分比在男性和女性之间存在差异（12 .+-. 1% vs. 53 .+-. 3%，P < 0.001），但在与冠状动脉疾病患病率相匹配的亚组中没有观察到这种差异。显然，负荷试验预测冠状动脉疾病的能力在异质人群中是有限的，在异质人群中，疾病的患病率可以通过胸痛和患者性别的分类来估计。
To determine to what extent the diagnostic accuracy of stress testing is influenced by the prevalence of coronary-artery disease, the description of chest pain, the result of stress testing and the results of coronary arteriography in 1465 men and 580 women from a multicentered clinical trial were correlated. The pre-test risk (prevalence of coronary-artery disease) varied from 7-87% depending on sex and classification of chest pain. A positive stress test increased the pre-test risk by only 6-20%, but a negative test decreased the risk by only 2-28%. Although the percentage of false-positive results differed between men and women (12 .+-. 1% vs. 53 .+-. 3%, P < 0.001), this difference was not seen in a subgroup matched for prevalence of coronary-artery disease. Apparently the ability of stress testing to predict coronary-artery disease is limited in a heterogeneous population in which the prevalence of disease can be estimated through classification of chest pain and the sex of the patient.