Low Predictive Value of Early Exercise Testing for Restenosis Following Successful PTCA

This study was designed to evaluate the predictive value of early exercise testing for the development of restenosis after successful PTCA. Thirty patients who had no ST segment changes (group A) and 20 patients who had ischemic ST segment depression more than 1 mm (group B) on treadmill exercise testing performed between the 2nd and 15 th days after PTCA were compared regarding some clinical and coronary angiographic findings. There were no significant difference with respect to age, sex, the history of stable, unstable angina, previous myocardial infarction, hypertension, diabetes, smoking, heredity, total cholesterol, HDL cholesterol and triglyceride levels between these two groups. Nor were there significant differences in the location and morphologic aspects of the stenotic lesions. Angiographic restenosis was detected in 7 (23 %) patients in group A and in 9 (45 %) patients in group B (p:ns), in 8 (24 %) of 38 lesions in group A and in 13 (48 %) of 27 lesions in group B (p<0.05). The sensitivity, specificity, positive and negative predictive value of early exercise testing for predicting angiographic restenosis were found to be 56 %, 67 %, 45 % and 76 %, respectively. Though restenosis is more common among patients who have a positive early exercise test, this finding's predictive value for restenosis is too low to have a practical value.