Abstract
Purpose: The American College of Cardiology/American Heart Association guidelines for exercise testing (ET) suggest that the usefulness of periodic ET in patients (pts) with stable coronary artery disease (CAD) is uncertain. The purpose of this study was to evaluate the prognostic value and clinical usefulness of routine treadmill ET in pts with stable CAD. Methods: Two hundred three pts with a mean age of 59.8±11.4 (176 males) with stable CAD underwent symptom limited maximum ET. The tests were considered positive if postexercise electrocardiogram showed ≥1 mm of ST depression 60 msec after the J point. During a mean follow-up period of 18 months, the incidence or coronary events (death, myocardial infarction, hospitalization for unstable angina or revascularization procedures) were compared between patients with positive and negative ET. Any change in medical therapy on the basis of the ET was also compared between the two groups. Results: Thirteen coronary events (0 death, 0 myocardial infarction) occurred in 38 pts with a positive ET (Group A), compared to 23 events (0 death, 1 myocardial infarction) in 165 pts with a negative ET (Group B) (p <0.001). Following the ET 17 of 38 pts in Group A had a change in medical management compared to 10 of 165 pts in Group B (p