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Epidemiologic study of asymptomatic men screened by maximal treadmill testing for latent coronary artery disease
Authors:Victor F. Froelicher Jr. MAJ   USAF   MC   Mary M. Thomas USAF   NC   Lt Col.   Charles Pillow S SGT   USAF  Malcolm C. Lancaster FACC   COL. USAF   MC
Affiliation:

From the Clinical Sciences Division. U. S. Air Force School of Aerospace Medicine, Aerospace Medical Division A.F.S.C., U. S. Air Force, Brooks Air Force Base, Texas, USA

Abstract:
A group of 1,390 asymptomatic men screened for latent coronary artery disease by maximal treadmill testing and double Master two-step test were followed up for a mean of 6.3 years. Angina, sudden death or acute myocardial infarction was used as the end point for coronary heart disease. There were differences in testing sensitivity and specificity among age and subject groups, but maximal treadmill testing out-performed the double Master test as a screening technique. Maximal treadmill testing demonstrated a 60.9 percent sensitivity, 92 percent specificity and a 20 percent probability that coronary artery disease would develop in a subject with an abnormal response. A risk ratio of 14.3 was obtained and demonstrated that maximal treadmill testing was a valuable screening technique for latent coronary artery disease. However, limitations of the sensitivity and specificity of the functional S-T segment response were apparent. The abnormal S-T segment response to exercise testing did not absolutely predict the future presentation of coronary artery disease, and a normal response to maximal treadmill testing did not rule out this possibility. Because premature ventricular contractions demonstrated a very low sensitivity, predictive value and risk ratio they were not a practical indicator of increased risk for latent coronary artery disease except when associated with an abnormal S-T segment response.
Keywords:Address for reprints: Victor F. Froelicher   Maj   USAF MC   Cardiopulmonary Section   NGI   School of Aerospace Medicine   Brooks Air Force Base   Texas 78235.
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