ArticleJournal of the American College of Cardiology2014
Yield of downstream tests after exercise treadmill testing: a prospective cohort study.
Article in Journal of the American College of Cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Clinical and Economic Implications of Inconclusive Noninvasive Test Results in Stable Patients With Suspected Coronary Artery Disease: Insights From the PROMISE Trial.Circulation. Cardiovascular imaging · 2020Trial
- Repositioning of exercise treadmill testing in contemporary chest pain management.The international journal of cardiovascular imaging · 2026Review
- Exercise Stress Testing in Clinical Cardiology: A Practical Guide to Performance and Interpretation.Journal of clinical medicine · 2026Review
- Deep learning analysis of exercise stress electrocardiography for identification of significant coronary artery disease.Frontiers in artificial intelligence · 2025Article
- Position Statement on Ischemic Heart Disease - Women-Centered Health Care - 2023.Arquivos brasileiros de cardiologia · 2023Article
- Downstream Imaging Studies Do Not Significantly Improve Outcome in Most Patients with Chest Pain Who Did Not Reach Their Target Heart Rate on a Stress ECHO Study.Journal of clinical medicine · 2023Article
- Quality metrics for single-photon emission computed tomography myocardial perfusion imaging: an ASNC information statement.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Review
- Improved Performance of PET Myocardial Perfusion Imaging Compared to SPECT in the Evaluation of Suspected CAD.Current cardiology reports · 2023Review
- Beyond traditional cardiovascular risk factors: Could frailty and other morbidities explain the worse prognosis in patients undergoing pharmacologic stress?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Role of Exercise Treadmill Testing in the Assessment of Coronary Microvascular Disease.JACC. Cardiovascular imaging · 2022Article
- Prognostic value of vasodilator stress perfusion cardiovascular magnetic resonance after inconclusive stress testing.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021Article
- Ten things to know about ten imaging studies: A preventive cardiology perspective ("ASPC top ten imaging").American journal of preventive cardiology · 2021Review
- Clinical judgement in chest pain: a case report.Journal of medical case reports · 2021Article
- Revisiting Application of Exercise Electrocardiography in Patients with Stable Ischemic Heart Disease.Korean circulation journal · 2020Article
- Automated Identification and Extraction of Exercise Treadmill Test Results.Journal of the American Heart Association · 2020Article
- Long-Term Outcomes in Patients Undergoing Percutaneous Coronary Intervention with or without Preprocedural Exercise Stress Test.Journal of Korean medical science · 2020Article
- Limited Use of Outpatient Stress Testing in Young Patients With Atypical Chest Pain.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2018Article
- Non-invasive assessment of low- and intermediate-risk patients with chest pain.Trends in cardiovascular medicine · 2017Review
- Anomalous origin of the coronary artery arising from the opposite sinus: prevalence and outcomes in patients undergoing coronary CTA.European heart journal. Cardiovascular Imaging · 2017Article
- Noninvasive Imaging to Evaluate Women With Stable Ischemic Heart Disease.JACC. Cardiovascular imaging · 2016Review
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12 authors.
Funding
Abstract
objectivesThe purpose of this study was to estimate the frequency and results of downstream testing after exercise treadmill tests (ETTs).
backgroundThe utility of additional diagnostic testing after ETT is not well characterized.
methodsWe followed consecutive individuals without known coronary artery disease referred for clinical ETT at a large medical center. We measured the frequency and results of downstream imaging tests and invasive angiography within 6 months of ETT and the combined endpoint of survival free from cardiovascular death, myocardial infarction, and coronary revascularization.
resultsAmong 3,656 consecutive subjects who were followed for a mean of 2.5 ± 1.1 years, 332 (9.0%) underwent noninvasive imaging and 84 (2.3%) were referred directly to invasive angiography after ETT. The combined endpoint occurred in 76 (2.2%) patients. The annual incidence of the combined endpoint after negative, inconclusive, and positive ETT was 0.2%, 1.3%, and 12.4%, respectively (p < 0.001). Rapid recovery of electrocardiography (ECG) changes during ETT was associated with negative downstream test results and excellent prognosis, whereas typical angina despite negative ECG was associated with positive downstream tests and adverse prognosis (p < 0.001). Younger age, female sex, higher metabolic equivalents of task achieved, and rapid recovery of ECG changes were predictors of negative downstream tests.
conclusionsAmong patients referred for additional testing after ETT, the lowest yield was observed among individuals with rapid recovery of ECG changes or negative ETT, whereas the highest yield was observed among those with typical angina despite negative ECG or a positive ETT. These findings may be used to identify patients who are most and least likely to benefit from additional testing.
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