Angiographic Evaluation of ETT (Treadmill) Positive Patients in a Tertiary Care Hospital of Bangladesh

To evaluate the factors which predetermine the
coronary artery disease in patients having positive Exercise Tolerance
Test (ETT) that is treadmill results and coronary artery findings. This
descriptive study was conducted at Department of Cardiology,
Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh
from 1st January, 2014 to 31st August, 2014. All patients who had
done ETT (treadmill) for chest pain diagnosis were studied. One
hundred and four patients underwent coronary angiogram after
positive treadmill result. Patients were divided into two groups
depending upon the angiographic findings, i.e. true positive and false
positive. Positive treadmill test patients who have coronary artery
involvement these are called true positive and who have no
involvement they are called false positive group. Both groups were
compared with each other. Out of 104 patients, 81 (77.9%) patients
had true positive ETT and 23 (22.1%) patients had false positive
ETT. The mean age of patients in positive ETT was 53.46± 8.06
years and male mean age was 53.63±8.36 years and female was
52.87±7.0 years. Sixty nine (85.19%) male patients and twelve
(14.81%) female patients had true positive ETT, whereas 15
(65.21%) males and 8 (34.79%) females had false positive ETT, this
was statistically significant (p<0.032) in the two groups (sex) in
comparison of true and false positive ETT. The risk factors of these
patients like diabetes mellitus, hypertension, dyslipidemia, family
history and smoking were seen among these patients. Hypertensive
patients having true positive which were statistically significant
(p<0.004) and diabetic, dyslipidemic patients having true positive
which were statistically significant (p<0.032 & 0.030).True positive
patients had family history were 68(83.95%) and smoking were 52
(64.20%), where family history patients had statistically significant
(p<0.017) between two groups of patients and smokers were
significant (p<0.012). 46 true positive patients achieved THR which
was not statistically significant (P<0.138) and 79 true patients had
abnormal resting ECG whether it was significant (p<0.036). Amongst
the vessels involvement the most common was LAD 55 (67.90 %)
followed by LCX 42 (51.85%), RCA 36 (44.44%), and the LMCA
was 9 (11.11%). 40 patients (49.38%) had SVD, 26 (30.10%) had
DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. It
can be concluded that among the female patients who have positive
ETT with normal resting ECG, who had achieved target heart rate are
likely to have a false positive test result. Conversely male patients,
resting abnormal ECG who had not achieved THR, symptom limited
ETT, have a hypertension, diabetes, dyslipidemia, family history and
smoking are likely to have a true positive treadmill test result.

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