This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Bradley L. Hubbard, MD; Raymond J. Gibbons, MD; Andre C. Lapeyre III, MD; Alan R. Zinsmeister, PhD; Ian P. Clements, MD

Arch Intern Med. 1992;152(2):309-312.

Abstract
The purpose of our study was to examine the ability of clinical and resting electrocardiographic variables to provide useful estimates of the probability of three-vessel or left-main coronary artery disease. The study group consisted of 680 patients with symptomatic coronary artery disease who underwent exercise equilibrium radionuclide angiography and coronary angiography within 6 months. Sixteen clinical and electrocardiographic variables were examined by logistic regression analysis. The independently predictive variables were then used to develop convenient graphic estimates of the probability of three-vessel or left-main disease and to classify patients into high-risk (>35%), intermediate-risk (15-35%), or low-risk (<15%) groups. Five variables were independently predictive of left-main or three-vessel disease: age, typical angina, diabetes, gender, and both history and electrocardiographic evidence of a prior myocardial infarction. A single graph was constructed that displayed the probability of severe coronary artery disease as a function of a five-point cardiac risk scale, which incorporated these variables. Two hundred sixty-two patients (39% of the study group) were classified as high risk; 127 of these patients (48%) had three-vessel or left-main disease. An additional 96 patients were classified as low risk; nine of these patients (9%) had three-vessel or left-main disease. Five clinical variables that were obtained on an initial patient assessment can provide useful estimates of the likelihood of severe coronary disease.

(Arch Intern Med. 1992;152:309-312)

Author Affiliations
From the Division of Cardiovascular Disease and Internal Medicine (Drs Hubbard, Gibbons, Lapeyre, and Clements) and the Section of Biostatistics (Dr Zinsmeister), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Footnotes
Accepted for publication September 9, 1991.

Reprint requests to the Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr Gibbons).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery
American College of Cardiology Foundation et al.
J Am Coll Cardiol 2009;54:e13-e118.
FULL TEXT  

2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
2007 WRITING COMMITTEE MEMBERS et al.
Circulation 2009;120:e169-e276.
FULL TEXT  

CHAPTER 17 Chronic Ischaemic Heart Disease
Crea et al.
ESC Textbook of Cardiovascular Medicine 2009;2:med-9780199566990-chapter-med-9780199566990-chapter.
ABSTRACT | FULL TEXT  

An Externally Validated Model for Predicting Long-Term Survival after Exercise Treadmill Testing in Patients with Suspected Coronary Artery Disease and a Normal Electrocardiogram
Lauer et al.
ANN INTERN MED 2007;147:821-828.
ABSTRACT | FULL TEXT  

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery
Fleisher et al.
J Am Coll Cardiol 2007;50:e159-e242.
FULL TEXT  

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
Fleisher et al.
Circulation 2007;116:e418-e500.
FULL TEXT  

The Value of Myocardial Perfusion Single-Photon Emission Computed Tomography in Screening Asymptomatic Patients With Atrial Fibrillation for Coronary Artery Disease
Askew et al.
J Am Coll Cardiol 2007;50:1080-1085.
ABSTRACT | FULL TEXT  

Preoperative Hematocrit Levels and Postoperative Outcomes in Older Patients Undergoing Noncardiac Surgery
Wu et al.
JAMA 2007;297:2481-2488.
ABSTRACT | FULL TEXT  

Value of Vasodilator Left Ventricular Ejection Fraction Reserve in Evaluating the Magnitude of Myocardium at Risk and the Extent of Angiographic Coronary Artery Disease: A 82Rb PET/CT Study
Dorbala et al.
JNM 2007;48:349-358.
ABSTRACT | FULL TEXT  

Development of a Score to Predict the Need for Coronary Artery Bypass Graft Surgery in Patients With Non-ST Segment Elevation Acute Coronary Syndromes
Garcia et al.
Ann. Thorac. Surg. 2004;78:2022-2026.
ABSTRACT | FULL TEXT  

Utility of myocardial perfusion imaging in patients with low-risk treadmill scores
Poornima et al.
J Am Coll Cardiol 2004;43:194-199.
ABSTRACT | FULL TEXT  

Risk stratification using stress myocardial perfusion imaging: don't neglect the value of clinical variables
Beller and Watson
J Am Coll Cardiol 2004;43:209-212.
FULL TEXT  

Use of a Simple Clinical Score to Predict Prognosis of Patients With Normal or Mildly Abnormal Resting Electrocardiographic Findings Undergoing Evaluation for Coronary Artery Disease
Ho et al.
Mayo Clin Proc. 2002;77:515-521.
ABSTRACT  

Aspirin Use and All-Cause Mortality Among Patients Being Evaluated for Known or Suspected Coronary Artery Disease: A Propensity Analysis
Gum et al.
JAMA 2001;286:1187-1194.
ABSTRACT | FULL TEXT  

Heart Rate Recovery and Treadmill Exercise Score as Predictors of Mortality in Patients Referred for Exercise ECG
Nishime et al.
JAMA 2000;284:1392-1398.
ABSTRACT | FULL TEXT  

Identification of risk factors for increased cost, charges, and length of stay for cardiac patients
MaWhinney et al.
Ann. Thorac. Surg. 2000;70:702-710.
ABSTRACT | FULL TEXT  

ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina)
Gibbons et al.
J Am Coll Cardiol 1999;33:2092-2197.
FULL TEXT  

Preoperative Cardiac Preparation
Belzberg and Rivkind
Chest 1999;115 :82S-95S.
ABSTRACT | FULL TEXT  

Cardiovascular Health and Disease in Women
Wenger et al.
NEJM 1993;329:247-256.
FULL TEXT