ST-changes in ECG at rest or during exercise indicate a high risk of severe coronary lesions after an episode of unstable coronary artery disease.

After an episode of unstable coronary artery disease, 190 patients performed a predischarge exercise test. A postdischarge exercise test and coronary angiography was performed by 172 patients after 1 month. A subgroup of 104 men performed both exercise tests with a computer-aided system. More sophisticated methods of evaluating the ECG reaction during exercise were not diagnostically superior to the simple identification of ST-depression of > or = 0.1 mV. ST-depression in ECG at rest indicated a 70% risk of severe coronary lesions and in such patients, the ECG reaction at exercise carried no additional diagnostic information. Stepwise multiple regression analysis showed that ST-depression and low maximal work load were the most important exercise variables for identification of severe coronary lesions. Using a combination of these parameters, the sensitivity and specificity for identification of severe coronary lesions were, respectively, 77% and 61% predischarge and 77% and 70% after 1 month.

RCT Entities:   Population Interventions Outcomes