Incremental prognostic value of the exercise electrocardiogram in the initial assessment of patients with suspected angina: cohort study
2008

Prognostic Value of Exercise ECG in Angina Patients

Sample size: 8176 publication 10 minutes Evidence: moderate

Author Information

Author(s): Neha Sekhri, Gene S Feder, Cornelia Junghans, Sandra Eldridge, Athavan Umaipalan, Rashmi Madhu, Harry Hemingway, Adam D Timmis

Primary Institution: Newham University Hospital, London

Hypothesis

Do resting and exercise electrocardiograms provide additional prognostic value beyond clinical history in patients with suspected angina?

Conclusion

Basic clinical assessment provides most of the prognostic value for patients with suspected angina, with limited additional value from resting and exercise ECGs.

Supporting Evidence

  • The study included 8176 patients with suspected angina.
  • The median follow-up period was 2.46 years.
  • Only small differences in risk stratification were observed across different ECG models.

Takeaway

Doctors can often tell how serious chest pain is just by asking questions, and extra tests like ECGs don't help much more.

Methodology

Multicentre cohort study involving 8176 patients with suspected angina, assessing the prognostic value of resting and exercise ECGs.

Potential Biases

Potential selection bias as previous studies focused on patients with known coronary artery disease.

Limitations

Lack of data on lipid levels and family history, which could improve risk assessment.

Participant Demographics

{"mean_age":55,"gender_distribution":{"male":53,"female":47},"ethnicity":{"white":72,"south_asian":28}}

Statistical Information

P-Value

<0.001

Confidence Interval

0.68 to 0.82

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1136/bmj.a2240

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