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Prognostic value of the duke treadmill score in asymptomatic women.
Am J Cardiol. 2005 Aug 01; 96(3):369-75.AJ

Abstract

The Duke Treadmill Score (DTS) has been shown to predict mortality in women who have symptomatic heart disease, but its ability to do so in asymptomatic women is unknown, as is its comparative advantage to exercise capacity. We investigated whether a decreased DTS is associated with increased mortality in a prospective cohort of 5,636 asymptomatic women. A symptom-limited exercise treadmill test using Bruce's protocol was performed at baseline. DTS was calculated using exercise time, exercise-induced angina, and ST-segment depression. Exercise capacity was measured in METs. Deaths and cause of death were identified from 1992 to 2000. After adjusting for the Framingham Risk Score, the risk of death decreased by 9% for each unit increase in DTS and by 17% for every 1-MET increase (p <0.001). Those who had a DTS <5 (moderate or high risk) had hazard ratios for death and cardiac death that were 2.2 and 2.5 times greater, respectively, than did those who had a DTS > or =5 (low risk), after adjusting for Framingham Risk Score (p <0.001). Receiver-operating characteristic curves for the DTS model and the exercise capacity model were not significantly different. In conclusion, we have demonstrated that, although the DTS is an independent predictor of mortality and cardiac mortality in asymptomatic women, it does not appear to be a better predictor than exercise capacity alone. The role of ST-segment changes and symptoms with stress testing in asymptomatic women does not provide additional prognostic information.

Authors+Show Affiliations

Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA. MGulati@nmff.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16054460

Citation

Gulati, Martha, et al. "Prognostic Value of the Duke Treadmill Score in Asymptomatic Women." The American Journal of Cardiology, vol. 96, no. 3, 2005, pp. 369-75.
Gulati M, Arnsdorf MF, Shaw LJ, et al. Prognostic value of the duke treadmill score in asymptomatic women. Am J Cardiol. 2005;96(3):369-75.
Gulati, M., Arnsdorf, M. F., Shaw, L. J., Pandey, D. K., Thisted, R. A., Lauderdale, D. S., Wicklund, R. H., Al-Hani, A. J., & Black, H. R. (2005). Prognostic value of the duke treadmill score in asymptomatic women. The American Journal of Cardiology, 96(3), 369-75.
Gulati M, et al. Prognostic Value of the Duke Treadmill Score in Asymptomatic Women. Am J Cardiol. 2005 Aug 1;96(3):369-75. PubMed PMID: 16054460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of the duke treadmill score in asymptomatic women. AU - Gulati,Martha, AU - Arnsdorf,Morton F, AU - Shaw,Leslee J, AU - Pandey,Dilip K, AU - Thisted,Ronald A, AU - Lauderdale,Diane S, AU - Wicklund,Roxanne H, AU - Al-Hani,Arfan J, AU - Black,Henry R, PY - 2005/01/18/received PY - 2005/03/17/revised PY - 2005/03/17/accepted PY - 2005/8/2/pubmed PY - 2005/9/15/medline PY - 2005/8/2/entrez SP - 369 EP - 75 JF - The American journal of cardiology JO - Am J Cardiol VL - 96 IS - 3 N2 - The Duke Treadmill Score (DTS) has been shown to predict mortality in women who have symptomatic heart disease, but its ability to do so in asymptomatic women is unknown, as is its comparative advantage to exercise capacity. We investigated whether a decreased DTS is associated with increased mortality in a prospective cohort of 5,636 asymptomatic women. A symptom-limited exercise treadmill test using Bruce's protocol was performed at baseline. DTS was calculated using exercise time, exercise-induced angina, and ST-segment depression. Exercise capacity was measured in METs. Deaths and cause of death were identified from 1992 to 2000. After adjusting for the Framingham Risk Score, the risk of death decreased by 9% for each unit increase in DTS and by 17% for every 1-MET increase (p <0.001). Those who had a DTS <5 (moderate or high risk) had hazard ratios for death and cardiac death that were 2.2 and 2.5 times greater, respectively, than did those who had a DTS > or =5 (low risk), after adjusting for Framingham Risk Score (p <0.001). Receiver-operating characteristic curves for the DTS model and the exercise capacity model were not significantly different. In conclusion, we have demonstrated that, although the DTS is an independent predictor of mortality and cardiac mortality in asymptomatic women, it does not appear to be a better predictor than exercise capacity alone. The role of ST-segment changes and symptoms with stress testing in asymptomatic women does not provide additional prognostic information. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/16054460/Prognostic_value_of_the_duke_treadmill_score_in_asymptomatic_women_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(05)00734-4 DB - PRIME DP - Unbound Medicine ER -