Increase in Delta ST/Delta heart rate (HR) index: A new predictor of restenosis After successful percutaneous transluminal coronary angioplasty

被引:9
作者
Hamasaki, S [1 ]
Arima, S [1 ]
Tahara, M [1 ]
Kihara, K [1 ]
Shono, H [1 ]
Nakao, S [1 ]
Tanaka, H [1 ]
机构
[1] KAGOSHIMA UNIV,FAC MED,DEPT INTERNAL MED 1,KAGOSHIMA 890,JAPAN
关键词
D O I
10.1016/S0002-9149(96)00522-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
With the goal of improving the prediction of restenosis after percutaneous transluminal coronary angioplasty (PTCA), we evaluated the usefulness of the Delta ST/Delta heart rate (HR) index derived from serial exercise treadmill tests. Exercise treadmill tests were performed by 125 patients with single-vessel coronary artery disease before and several days after PTCA, and lust before followup angiography 3 to 12 months later. Simple HR-adjusted indexes of ST-segment depression during exercise (Delta ST/Delta HR index) were derived. We compared the usefulness of the increase in Delta ST/Delta HR index at follow-up over the value obtained several days after PTCA for prediction of restenosis with that of a positive exercise treadmill test and a positive thallium scintigram at follow-up. At follow-up, 47 of the 125 patients showed restenosis. The Delta ST/Delta HR index increased in 43 of 47 patients in the restenosis group and in 18 of 78 patients without restenosis (p < 0.0001). Separate analysis of each criterion revealed the following respective values for sensitivity, specificity, and positive and negative predictive valves for prediction of restenosis: increased Delta ST/Delta HR index at follow-vp: 91%, 77%, 70%, and 94%; positive exercise treadmill test: 83%, 65%, 59%, and 86%; and positive thallium scintigram: 79%, 78%, 69%, and 86%. The increased Delta ST/Delta HR index had a significantly (p < 0.05) higher sensitivity than the positive thallium scintigram and a significantly (p < 0.01) higher specificity than the positive exercise treadmill test. An increased Delta ST/Delta HR index at follow-up identifies subgroups of patients who are at high risk for restenosis after PTCA. (C) 1996 by Excerpta Medica, Inc.
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页码:990 / 995
页数:6
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