Egloff C, Merola P, Schiavon C, Schiavinato M L, Modena F, Stritoni P, Corbara F, Miraglia G
Division of Cardiology, University of Padua, Italy.
Am J Cardiol. 1987 Nov 1;60(13):1006-8. doi: 10.1016/0002-9149(87)90342-0.
One hundred forty-three subjects (107 with coronary artery disease [CAD], 23 without CAD [evaluated by coronary angiography] and 13 athletes) were selected for this study. All subjects underwent exercise testing to evaluate sensitivity, specificity and predictive value of Q wave, QX/QT ratio, QTc interval and ST depression. The Q-wave analysis revealed less sensitivity (49%) and less specificity (83%) than ST depression (71% and 97%, respectively). The QTc criterion had greater sensitivity (80%) than ST depression but less specificity (11%). The QX/QT criterion was no different in sensitivity (74%) but had less specificity (69%). To establish the statistical evaluation of the positive predictive value in CAD, variations in the prevalence of the disease were considered. A 90% prevalence gives the best positive predictive value on all evaluated measurements, between 100% for ST depression and 89% for the QTc criterion. A 5% prevalence, however, gives an acceptable positive predictive value only on ST-segment depression (57%).
本研究选取了143名受试者（107名患有冠状动脉疾病[CAD]，23名无CAD[通过冠状动脉造影评估]以及13名运动员）。所有受试者均接受运动测试，以评估Q波、QX/QT比值、QTc间期和ST段压低的敏感性、特异性和预测价值。Q波分析显示，其敏感性（49%）和特异性（83%）均低于ST段压低（分别为71%和97%）。QTc标准的敏感性（80%）高于ST段压低，但特异性较低（11%）。QX/QT标准的敏感性（74%）无差异，但特异性较低（69%）。为了建立CAD中阳性预测值的统计学评估，考虑了疾病患病率的变化。90%的患病率在所有评估测量中给出了最佳的阳性预测值，ST段压低为100%，QTc标准为89%。然而，5%的患病率仅在ST段压低时给出了可接受的阳性预测值（57%）。
