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The false positive stress test

1977; Elsevier BV; Volume: 40; Issue: 5 Linguagem: Inglês

10.1016/0002-9149(77)90182-5

1879-1913

Myrvin Ellestad, Saul P. Savitz, David Bergdall, James Teske,

Cardiovascular Disease and Adiposity

Factors causing the false positive stress test and the ability of the computer to improve test classification were studied in 95 patients with a positive stress test and normal coronary angiograms and 125 patients with a true positive stress test. Multivariate analysis revealed that in men the following clinical findings other than S-T depression were useful in correct stress test classification: (1) maximal heart rate, (2) maximal systolic blood pressure, (3) contour of S-T segment, (4) age, (5) history of chest pain, (6) T waves in resting record, (7) chest pain during test, (8) S-T and T changes with hyperventilation, (9) resting electrocardiogram, (10) time of onset of S-T depression, and (11) increase in P wave negativity in lead V1 with exercise. These variables, presented in order of importance, had a different ranking in women. With this technique 65 percent of false positive tests were reclassified correctly, whereas they were 100 percent in error using exercise electrocardiographic changes alone. The overall error in all categories was reduced in men from 44 to 21 percent and in women from 63 to 27 percent. Only 13 percent of subjects with a false positive test had no hemodynamic abnormality. The data collected from analyzing the abnormalities in ventricular function suggest that there are few truly false positive tests and that computer processing can significantly improve classification according to the presence of coronary artery disease.