The predictive value of the time course of ST segment depression during exercise testing in patients referred for coronary angiograms.

We studied the time course of ST segment depression during and after exercise testing in 462 subjects who also had coronary angiograms. Sixty-three percent of patients with late onset-early offset ST depression, previously reported to be likely to have false positive tests, had significant coronary artery disease, and 32% had three-vessel disease. Those with early onset and late offset ST depression and those with resting ST depression that was accentuated with exercise had a high prevalence of significant coronary artery disease and three-vessel disease. We found that observation of the time course of ST depression during and after exercise adds significantly to the information gained during exercise testing.