Clinical study of risk stratification of coronary artery disease in high-risk patients by Treadmill stress test

Abstract

Background: Stress testing is a simple, reliable and excellent non-invasive method for
diagnosing coronary artery disease in asymptomatic patient and predicting future coronary
events, particularly in patient with coronary risk factors. Present study was aimed to study
risk stratification of coronary artery disease in high-risk patients by Treadmill stress test.
Material and Methods: Present study was single-center, Cross sectional, observational
study, conducted in patients of 30-70 years of age with, asymptomatic with increased risk of
developing ischemic heart disease (hypertension, Diabetes Mellitus, smoking,
hyperlipidemia, obesity, Type A personality and sedentary lifestyle). Treadmill was
performed according to ‘Bruce’ protocol. Results: Among 200 patients, 138 (69%) were
male and 62 (31%) were females. Out of 138 Male patients 39 (79.5%) showed positive
treadmill test and of 62 female patient 10(20.4%) showed positive treadmill test. Out of 49
positive treadmill tests, 27 patients (55.1%) were above the age group 50 years and 22 were
below 50 years. Majority patients having diabetes mellitus as a sole risk factor (38.7%)
showed positive treadmill test results followed by hypertensive patients (33.3%). In between
hypertension and diabetes, as per chi square test p value was 0.8414 (>0.05) which was not
significant. 17 (8.5%) patients had Exercise induced Hypotension during test. 17 (8.5 %) had
noted Chronotropic incompetence. 168 (84%) case were had MHR achieved in stage III, 29
(14.5%) were achieved MHR in stage II and remaining 3 (1.5%) were had achieved MHR in
stage I (high risk to develop coronary artery disease). Common reasons to terminate tread
mill exercise test were chest pain (27.5 %) followed by dyspnea (24 %), dizziness (15.5 %)
& fatigue (14.5 %). Most of patients achieved MET SCORE > 7 (70.5%) & 27 (13.5%) were
achieved MET SCORE between 6.1 to 7. Conclusion: Treadmill stress test is the only
noninvasive, reliable and cost-effective tool for diagnosis and better prognosis of coronary
artery disease