ACC/AHA 2002 Guideline Update for Exercise Testing: Summary Article

Gibbons, Raymond J.; Balady, Gary J.; Bricker, J. Timothy; Chaitman, Bernard R.; Fletcher, Gerald F.; Froelicher, Victor; Mark, Daniel B.; McCallister, Ben D.; Mooss, Aryan N.; O'Reilly, Michael G.; Winters, William L.; Antman, Elliott M.; Alpert, Joseph S.; Faxon, David P.; Fuster, Valentı́n; Gregoratos, Gabriel; Hiratzka, Loren F.; Jacobs, Alice K.; Russell, Richard O.; Smith, Sidney C.

doi:10.1161/01.cir.0000034670.06526.15

Cited by 1,515 publications

(428 citation statements)

References 44 publications

(20 reference statements)

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“…According to the current guidelines, patients discontinued medicines that could affect the exercise testing 48 hours before the test 18. Patients performed the exercise test after a three-hour fast and they were not allowed to drink tea/coffee or smoke before the test.…”

Section: Exercise Testingmentioning

confidence: 99%

“…Criteria for a positive exercise test were determined as an abnormal ST-segment response, or other criteria for positive exercise testing [drop in systolic blood pressure > 10 mmHg from baseline blood pressure despite an increase in workload, when accompanied by other evidence of ischaemia; moderate to severe angina; sustained ventricular tachycardia; ST elevation (≥ 1.0 mm) in leads without diagnostic Q waves (other than V1 or avR)] 18. Patients with a positive exercise test were placed in the positive exercise group.…”

Section: Exercise Testingmentioning

confidence: 99%

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Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Başkurt¹,

Aktürk²,

Keskin³

et al. 2011

CardioVascular Journal of Africa

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AimThe aim of this study was to detect any relationship between serum high-sensitivity C-reactive protein (hs-CRP), serum amyloid-associated protein (SAA) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and reversible myocardial ischaemia during cardiovascular exercise tests and to determine whether these biomarkers could predict transient myocardial ischaemia.MethodsNinety-six patients (36 women, 60 men, mean age 57 ± 8.5 years) were included in the study. Venous blood samples were taken from patients before and 15 minutes after exercise testing. SAA and hs-CRP were analysed using immunonephelometric assays (Dade-Behring, BN II, Marburg, Germany). NT-proBNP (pg/ml) was determined using the immulite 1 000 chemiluminescence immunoassay system (Siemens Medical Solution Diagnostics, Deerfiled, USA). Forty-eight patients (18 women, 30 men) with positive exercise tests were allocated to the exercise-positive group and 48 (18 women, 30 men) with negative exercise tests were put in the exercise-negative group. Coronary angiography was performed on all patients in the exercise-positive group.ResultsThere was no difference between the levels of hs-CRP, SAA and NT-pro-BNP before and after exercise testing in both of the exercise groups.ConclusionSerum levels of hs-CRP, SAA and NT-proBNP could not predict the occurrence of reversible myocardial ischaemia during exercise. Large-scale clinical studies are needed to clarify the status of hs-CRP, SAA and NT-proBNP with exercise.

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Section: Exercise Testingmentioning

confidence: 99%

Section: Exercise Testingmentioning

confidence: 99%

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Başkurt¹,

Aktürk²,

Keskin³

et al. 2011

CardioVascular Journal of Africa

View full text Add to dashboard Cite

show abstract

“…18 To achieve maximum heart rate, participants who were unable to continue the standard Bruce protocol (for orthopedic or other reasons) were switched to slower settings on the treadmill and encouraged to exercise for as long as possible. Continuous 12-lead electrocardiographic monitoring was performed throughout the testing, and exercise capacity was calculated as total metabolic equivalent tasks (METs) achieved at peak exercise (1 MET = 3.5 mL of oxygen uptake per kilogram of body weight per minute).…”

Section: Discussionmentioning

confidence: 99%

Association of Cystatin C With Poor Exercise Capacity and Heart Rate Recovery: Data From the Heart and Soul Study

McManus

Shlipak

et al. 2007

American Journal of Kidney Diseases

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Background-Cystatin C, an alternative serum measure of kidney function, is a stronger predictor of cardiovascular events than creatinine or estimated glomerular filtration rate (eGFR). We hypothesized that serum cystatin C concentration would have a stronger more linear association with cardiovascular functional status than creatinine-based measures in outpatients with established coronary heart disease (CHD).

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“…Part 1 described a patient presenting with chest pain who, according to the information provided, would have an intermediate pretest likelihood of obstructive CAD for a male or female patient 42. Part 2 described the same patient returning with continued episodes of chest pain and an abnormal exercise treadmill test (ETT; Duke Treadmill Score 5), again suggesting an intermediate likelihood of obstructive CAD regardless of gender.…”

Section: Methodsmentioning

confidence: 99%

Implicit Gender Bias and the Use of Cardiovascular Tests Among Cardiologists

Daugherty

Blair

Havranek

et al. 2017

JAHA

111

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BackgroundPhysicians' gender bias may contribute to gender disparities in cardiovascular testing. We used the Implicit Association Test to examine the association of implicit gender biases with decisions to use cardiovascular tests.Methods and ResultsIn 2014, cardiologists completed Implicit Association Tests and a clinical vignette with patient gender randomly assigned. The Implicit Association Tests measured implicit gender bias for the characteristics of strength and risk taking. The vignette represented an intermediate likelihood of coronary artery disease regardless of patient gender: chest pain (part 1) followed by an abnormal exercise treadmill test (part 2). Cardiologists rated the likelihood of coronary artery disease and the usefulness of stress testing and angiography for the assigned patient. Of the 503 respondents (9.3% of eligible; 87% male, median age of 45 years, 58% in private practice), the majority associated strength or risk taking implicitly with male more than female patients. The estimated likelihood of coronary artery disease for both parts of the vignette was similar by patient gender. The utility of secondary stress testing after an abnormal exercise treadmill test was rated as “high” more often for female than male patients (32.8% versus 24.3%, P=0.04); this difference did not vary with implicit bias. Angiography was more consistently rated as having “high” utility for male versus female patients (part 1: 19.7% versus 9.8%; part 2: 73.7% versus 64.3%; P<0.05 for both); this difference was larger for cardiologists with higher implicit gender bias on risk taking (P=0.01).ConclusionsCardiologists have varying degrees of implicit gender bias. This bias explained some, but not all, of the gender variability in simulated clinical decision‐making for suspected coronary artery disease.

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ACC/AHA 2002 Guideline Update for Exercise Testing: Summary Article

Cited by 1,515 publications

References 44 publications

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Association of Cystatin C With Poor Exercise Capacity and Heart Rate Recovery: Data From the Heart and Soul Study

Implicit Gender Bias and the Use of Cardiovascular Tests Among Cardiologists

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