Alexander K P, Shaw L J, Shaw L K, Delong E R, Mark D B, Peterson E D
Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
J Am Coll Cardiol. 1998 Nov 15;32(6):1657-64. doi: 10.1016/s0735-1097(98)00451-3.
We sought to determine the ability of a treadmill score to provide accurate diagnostic and prognostic risk estimates in women.
Treadmill testing has been reported to have a lower accuracy for diagnosis of chest pain in women. The diagnostic and prognostic value of the Duke Treadmill Score (DTS) in women is unknown.
We determined the diagnostic and prognostic value of the DTS in 976 women and 2,249 men who underwent both treadmill testing and cardiac catheterization in a single institution from 1984 to 1994.
Women and men differed significantly in DTS (1.6 vs. -0.3, p < 0.0001), disease prevalence (32% vs. 72% significant coronary artery disease [CAD], p < 0.001), and 2-year mortality (1.9% vs. 4.9%, p < 0.0001). The DTS provided information beyond clinical predictors of both coronary disease and survival in women and men. Although overall women had better survival, the DTS performed equally well in stratifying both genders into prognostic categories. The DTS actually performed better in women than in men for excluding disease, with fewer low risk women having any significant coronary disease (> or = 1 vessel with > or =75% stenosis) (20% vs. 47%, p < 0.001), or severe disease (3-vessel disease or > or =75% left main stenosis) (3.5% vs. 11.4%, p < 0.001).
By combining several aspects of treadmill testing, the DTS effectively stratifies women into diagnostic and prognostic risk categories.
我们试图确定跑步机评分在女性中提供准确诊断和预后风险评估的能力。
据报道，跑步机测试对女性胸痛的诊断准确性较低。杜克跑步机评分（DTS）在女性中的诊断和预后价值尚不清楚。
我们确定了1984年至1994年在单一机构接受跑步机测试和心脏导管插入术的976名女性和2249名男性中DTS的诊断和预后价值。
女性和男性在DTS（1.6对 -0.3，p < 0.0001）、疾病患病率（32%对72%显著冠状动脉疾病[CAD]，p < 0.001）和2年死亡率（1.9%对4.9%，p < 0.0001）方面存在显著差异。DTS提供了超出冠心病和女性及男性生存临床预测指标的信息。尽管总体上女性生存率更高，但DTS在将两性分层到预后类别方面表现同样出色。在排除疾病方面，DTS在女性中实际上比在男性中表现更好，患有任何显著冠状动脉疾病（≥1支血管有≥75%狭窄）的低风险女性更少（20%对47%，p < 0.001），或患有严重疾病（三支血管疾病或≥75%左主干狭窄）的低风险女性更少（3.5%对11.4%，p < 0.001）。
通过结合跑步机测试的几个方面，DTS有效地将女性分层到诊断和预后风险类别中。
