Exercise test, history, and serum lipid levels in patients with chest pain and normal electrocardiogram at rest: Comparison to findings at coronary arteriography

Abstract

In a series of 96 patients with chest pain, and a normal ECG at rest, the results of a GXT, the history, and the serum lipid levels were compared to the findings at coronary arteriography. In addition, in 91 subjects a modified two-step test was performed.

To characterize quantitatively and in one number the relation to the coronary arteriogram, use was made of the index of merit (T) which ranges from 0 to 1. The following indices were found: history, 0.59; GXT, 0.53; serum β-lipoprotein, 0.37; serum cholesterol, 0.28; and two-step test, 0.26.

In 30 subjects the statements of the history, the GXT, and serum β-lipoprotein were concordant. In this category the agreement with the coronary arteriogram was excellent (T = 0.93).

In 64 subjects the statements by the history and the GXT were concordant, but the serum β-lipoprotein level was at variance. For this group T = 0.82. For the entire series the best result was obtained if the decision was made according to two or three identical statements, which resulted in an index of merit of 0.67.