Correlation of coronary artery disease on coronary angiography with Dukes Treadmill score in patients undergoing Exercise tolerance test

Background:The exercise tolerance test (ETT) is a widely used, non-invasive diagnostic tool for evaluating coronary artery disease (CAD). Exercise testing, commonly referred to as an exercise tolerance test (ETT), is a widely utilized, non-invasive diagnostic modality for patients presenting with cardiac symptoms. Its utility extends across multiple dimensions of cardiovascular evaluation. The Duke Treadmill Score (DTS), one of the most extensively validated indices in exercise testing, was initially developed as a prognostic tool. Its original purpose was to predict long-term outcomes in patients with suspected coronary artery disease (CAD). Objective: To determine the correlation between Duke’s treadmill score & coronary angiography to detect CAD in patients presented with unstable angina. Methodology:This study was designed as a cross-sectional analysis; conducted atFaisalabad Institute of Cardiology, Faisalabad for 6months.Sample size of 96 patients was included through simple random sampling. Patients subjected to treadmill exercise and Duke’s treadmill score was calculated. The DTS typically sorts from -25 to +15. Then coronary angiography was performed in these patients. Each coronary lesion resulting in a ?50% diameter stenosis in vessels with a diameter of ?1.5 mm was assessed individually to propose the overall SyntaxScore. Predesigned questionnaire was filled.Data was entered and analyzed through SPSS v. 21. In this study, Pearson’s correlation coefficient (r) was employed to evaluate the strength and direction of linear relationships between continuous variables. P-value?0.05 wasconsidered as significant. Results:The study included 96 patients. Of them, 10 (10.4%) patients were female and 86(89.6%) were males. Groupscomprised as low-risk group, 48 patients (50%); intermediate-risk group, 20 patients (21%); and high-risk group, 28 patients (21%). The average age of the study population was 42±8 years.Demographic and laboratory findings of the groups classified as per SYNTAX score. Although ETT duration, ETT workload, BP at rest, and angina development during ETT were similar overall groups; percentage of maximum heart rate achieved, BP at peak, maximum ST deviation, and DTS differed significantly between the groups. Patients in high risk group as determined with DTS had more severe CAD as compared with those in low risk group. Conclusion:Our verdictspropose that surrogate markers derived from exercise treadmill testing (ETT) such as Duke Treadmill Score (DTS), ST deviation at peak and at recovery demonstrate strong correlations with the extent of CAD, and the development of major adverse cardiovascular events (MACE) during follow-up. These markers highlight their potential utility as non-invasive indicators for risk stratification, and predicting adverse cardiovascular outcomes.