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April 24, 1972

Diagnostic Accuracy of Two-Step Postexercise ECGResults in 305 Subjects Studied by Coronary Arteriography

JAMA. 1972;220(4):501-506. doi:10.1001/jama.1972.03200040023005

A total of 305 selected patients with chest pain syndromes were studied with both the two-step test and selective coronary cinearteriography. All patients were suspected clinically of having coronary artery disease. Subjects with positive responses were subdivided according to degree of ischemic R-ST depression, and those with negative responses according to immediate postexercise heart rate. Results of this study suggest that the diagnostic accuracy of a moderate stress test (such as the two-step) is greatly enhanced when postexercise heart rate, degree of R-ST depression, and presence of preexercise electrocardiographic abnormalities are considered. Retention of the two-step test as a screening procedure appears justified.