Prognostic Value of a Treadmill Exercise Score in Symptomatic Patients With Nonspecific ST-T Abnormalities on Resting ECG

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Abstract
Repolarization abnormalities—ST-segment depression and T-wave inversion or flattening—are the most common abnormalities on the resting electrocardiogram (ECG) in the general population and in patients who present with chest pain.1-4 Patients with ST-T abnormalities have a higher prevalence of coronary artery disease (CAD), severe CAD, left ventricular dysfunction, and higher cardiac morbidity and mortality than those with normal results on resting ECG.1-10 Although previous studies have shown that treadmill exercise testing is useful for the diagnosis of CAD in patients with ST-T abnormalities, the exercise ECG is considerably less specific then in patients with normal findings on resting ECGs.11-16 Thus, exercise testing for prognostic purposes in patients with resting ST-T abnormalities is problematic, since these patients are at higher risk yet have a less specific exercise ECG response for the diagnosis of CAD.