The value of the Duke treadmill score in predicting the presence and severity of coronary artery disease

Abstract

Background and aim: We aimed to investigate the role of the Duke treadmill score (DTS) in predicting the presence and severity of coronary artery disease (CAD) by using the SYNTAX score (SS), and also to determine the cut-off value of DTS for both the presence and severity of CAD.

Methods: The study population consisted of 267 patients admitted to the outpatient clinic with chest pain, who under­went coronary angiography after a positive treadmill stress test. First the patients were divided into two groups: SS = 0 and SS > 0. Then the SS > 0 patients were classified into two subgroups with low (1–22) and high (> 22) SS.

Results: There was a strong negative correlation between DTS and SS (r = –072, p < 0.001). The area under the receiv­er-operating curve of DTS was 0.83 (0.77–0.88, p < 0.001) for predicting a significant presence of CAD. The optimal cut-off value of DTS to predict the significant presence of CAD was –3.7 (sensitivity of 74% and specificity of 73%). The area under the receiver-operating curve of DTS was 0.84 (0.78–0.90, p < 0.001) for predicting high SS. The optimal cut-off value of DTS to predict high SS was –11.2 (sensitivity of 81% and specificity of 80%). DTS was found to be an independent predictor of high SS in multivariate analysis.

Conclusions: DTS can predict the presence and severity of stable CAD before coronary angiography and may enable the estimation of the revascularisation method that will be required after the procedure.