Prediction Of Treadmill Exercise Test To Preoperative Curative Effect Of PCI In Patients With Chronic Total Occlusion

Objective To explore the prediction of treadmill exercise test (TET) to preoperative curative effect of percutaneous coronary intervention (PCI) in the patients of chronic total occlusion (CTO) and the advantage of TET for the patients.Methods 6120 consecutive subjects admitted to Shandong Provincial Hospital and underwent all TET from 2009 to 2011 were analysed retrospectively. In order to evaluate the value of TET for diagnosis of CTO, comparative analysis was specially focused on those patients who were suspected for CTO and underwent both TET and Coronary Angiography (CAG).Results 6120 patients underwent TET during the study period. Among them men were 3370(55.1%)and women were 2750(44.9%). The mean age of the women was higher than the men(p<0.05). Patients with age of 40-60 years accounted for 30.7 %. The total positive rate of exercise treadmill test was 8%, which increased with age and the positive rate in the men was also higher than in the female (9.3%>6.9%, p< 0.05). The patients with symptom and suspected CTO accounted for the largest part of the total population (90.8%).323 patients suspected for CTO underwent both TET and CAG. The sensitivity of TET to diagnose coronary heart disease was 61% and the distinction was 81%. The detection rates of TET for LAD, LCX, RCA were 66.9%,57.3%,50% that there were no differences between them(p>0.05). The single influenced factors for fake positive results of TET included age, high blood pressure and smoking. The single influenced factors for fake negative results of TET included sex, age, amounts of coronary heart disease, occlusion, disease of branches, side branch circle and high fat of blood.Conclusion It is safe, sensitive and distinctive for TET to diagnosis and predict the preoperative curative effect of patients with CTO. It had moderate degree sensitivity but the specificity of TET is high. The diagnostic of TET may be more valuable in men. Analysis of the result of TET combining with multiple clinical factors will improve the accuracy of diagnosis of CTO.