Exercise stress test utility in patients with chest pain presumed to be of cardiac origin

Abstract

Introduction: NICE stated exercise stress tests (EST) should not be used to diagnose obstructive coronary artery disease in patients presenting with chest pain presumed to be of cardiac origin. Methods: A retrospective review of 209 patients with presumed cardiac chest pain was done. EST results, GRACE scores and need for invasive coronary angiogram (ICA) were analysed to predict the need for readmission, intervention and future events. Results: The sensitivity of the EST in identifying obstructive coronary artery disease was 70%. The EST, ICA and the GRACE 6-month mortality had a 77%, 70% and 81% negative predictive value (NPV) for readmission respectively. Conclusion: EST, GRACE scores and ICA are useful in providing prognostic information but are poor predictors of readmission. Follow up and education programmes are needed to reduce this burden. © 2013 Rila Publications Ltd.