@article{3084665,
    title = "A QRS score versus ST-segment changes during exercise testing: which is
the most reliable ischaemic marker after myocardial revascularisation?",
    author = "Michaelides, AP and Psomadaki, ZD and Andrikopoulos, GK and Aigyptiadou, and MNK and Dilaveris, PE and Richter, DJ and Kartalis, A and Stefanadis, CI and and Toutouzas, PK",
    journal = "Coronary Artery Disease",
    year = "2003",
    volume = "14",
    number = "8",
    pages = "527-532",
    publisher = "Lippincott, Williams & Wilkins",
    issn = "0954-6928, 1473-5830",
    doi = "10.1097/00019501-200312000-00002",
    keywords = "exercise testing; ST-segment depression; QRS score; restenosis;
revascularisation",
    abstract = "Background The diagnostic ability of exercise testing based on
ST-segment changes is low for the detection of restenosis after
percutaneous transluminal coronary angioplasty (PTCA) or ischaemia after
bypass surgery (CABG). The aim of this study was to improve the
diagnostic accuracy of exercise testing in patients with a history of
PTCA or CABG, with the implementation of a QRS score.
Methods We studied 128 post-PTCA patients (aged 49 8 years) and 104
post-CABG patients (aged 54 +/- 8 years), who had either positive
exercise tests with or without angina, or negative exercise tests with
continuing angina-like symptoms, and underwent cardiac catheterisation.
Results The univariate risk ratio of exercise-induced ST-segment
deviation to detect restenosis was 3.05 (p = 0.005) and 0.83 (p = 0.690)
in group A and group B patients, respectively. The univariate risk
ratios of abnormal QRS score values to detect restenosis were 32.1 (p <
0.001) and 18.8 (p < 0.001) for group A and group B patients,
respectively. The univariate risk ratios of the combination of
exercise-induced ST-segment changes and of abnormal QRS score values to
detect restenosis was 9.43 (p < 0.001) and 3.77 (p < 0.044) for group A
and group B patients, respectively. The value of the area under the ROC
curves is higher for the QRS score in group A patients, group B patients
and for the whole study population.
Conclusions QRS score values significantly improve the diagnostic
ability of ST-segment change-based exercise testing, for the assessment
of restenosis after PTCA or ischaemia after CABG. (C) 2003 Lippincott
Williams Wilkins."
}