Heart rate adjustment of exercise-induced ST-segment depression identifies men who benefit from a risk factor reduction program

Circulation

Volumn 96, Issue 9, 1997, Pages 2899-2904

  Okin, Peter M ^a   Prineas, Ronald J ^e   Grandits, Greg ^b   Rautaharju, Pentti M ^c   Cohen, Jerome D ^d   Crow, Richard S ^b   Kligfield, Paul ^a  

^a WEILL CORNELL MEDICAL CENTER   (United States)

^b UNIVERSITY OF MINNESOTA   (United States)

^c WAKE FOREST SCHOOL OF MEDICINE   (United States)

^d SAINT LOUIS UNIVERSITY   (United States)

^e New York Hosp Cornell Med Center ^*

Author keywords

Coronary disease; Electrocardiography; Exercise; Heart rate; Risk factors

Indexed keywords

ADULT; ARTICLE; BLOOD PRESSURE REGULATION; DISEASE SEVERITY; ELECTROCARDIOGRAPHY; EXERCISE TEST; HEART INDEX; HEART RATE; HIGH RISK POPULATION; HUMAN; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; RISK BENEFIT ANALYSIS; RISK FACTOR; ST SEGMENT DEPRESSION;

EID: 0030704292     PISSN: 00097322     EISSN: None     Source Type: Journal    
DOI: 10.1161/01.CIR.96.9.2899     Document Type: Article

References (43)

1. The Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383-1389.
2. Jukema JW, Bruschke AVG, van Boven AJ, Reiber JHC, Bal ET, Zwinderman AH, Jansen J, Boerma GJM, van Rappard FM, Lie KI on behalf of the REGRESS Study Group. Effects of lipid lowering by pravastatin on progression and regression of coronary artery disease in symptomatic men with normal to moderately elevated serum cholesterol levels: the Regression Growth Evaluation Statin Study (REGRESS). Circulation. 1995;91:2528-2540.
3. Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW, McKillop JH, Packard CJ for the West of Scotland Coronary Prevention Study Group. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med. 1995; 333:1301-1307.
4. A co-operative trial in the primary prevention of ischaemic heart disease using clofibrate: report from the Committee of Principal Investigators. Br Heart J. 1978;40:1069-1118.
5. The Lipid Research Clinics Coronary Primary Prevention Trial Results, I: reduction in incidence of coronary heart disease. JAMA. 1984;251:351-364.
6. The Lipid Research Clinics Coronary Primary Prevention Trial Results, II: the relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA. 1984;251:365-374.
7. Frick MH, Elo O, Haapa K, Heinonen OP, Heinsalmi P, Helo P, Huttunen JK, Kaitaniemi P, Koskinen P, Manninen V, Maenpaa H, Malkonen M, Manttari M, Norola S, Pasternack A, Pikkarainen J, Romo M, Sjoblom T, Nikkila EA. Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia: safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Engl J Med. 1987;317:1237-1245.
8. Muldoon MF, Manuck SB, Matthews KA. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. BMJ. 1990;301:309-314.
9. Mulrow CD, Cornell JA, Herrera CR, Kadri A, Farnett L, Aguilar C. Hypertension in the elderly: implications and generalizability of randomized trials. JAMA. 1994;272:1932-1938.
10. Pearce KA, Furberg CD, Rushing J. Does antihypertensive treatment of the elderly prevent cardiovascular events or prolong life? A meta-analysis of hypertension treatment trials. Arch Fam Med. 1995;4:943-949.
11. Hoes AW, Grobbee DE, Lubsen J. Does drug treatment improve survival? Reconciling the trials in mild-to-moderate hypertension. J Hypertens. 1995;13:805-811.
12. Mark DB, Hlatky MA, Harrell FE Jr, Lee KL, Califf RM, Pryor DB. Exercise treadmill score for predicting prognosis in coronary artery disease. Ann Intern Med. 1987;106:793-800.
13. Mark DB, Shaw L, Harrell FE Jr, Hlatky MA, Lee KL, Bengston JR, McCants CB, Califf RM, Pryor DB. Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. N Engl J Med. 1991;325:849-853.
14. Giagnoni E, Secchi MB, Wu SC, Morabito A, Oltrona L, Mancarella S, Volpin N, Fossa L, Arangio G, Sachero A, Folli G. Prognostic value of exercise EKG testing in asymptomatic normotensive subjects: a prospective matched study. N Engl J Med. 1983; 309:1085-1089.
15. Gordon DJ, Ekelund LG, Karon JM, Probstfield JL, Rubenstein C, Sheffield LT, Weissfeld L. Predictive value of the exercise tolerance test for mortality in North American Men: the Lipid Research Clinics Mortality Follow-up Study. Circulation. 1986;74:252-261.
16. Rautaharju PM, Prineas RJ, Eifler WJ, Furberg CD, Neaton JD, Crow RS, Stamler J, Cutler JA. Prognostic value of exercise electrocardiogram in men at high risk of future coronary heart disease: Multiple Risk Factor Intervention Trial experience. J Am Coll Cardiol. 1986;8:1-10.
17. Bruce RA, Hossack KF, DeRouen TA, Hofer V. Enhanced risk assessment for primary coronary heart disease events by maximal exercise testing: 10 years' experience of Seattle Heart Watch. J Am Coll Cardiol. 1983;2:565-573.
18. Okin PM, Anderson KM, Levy D, Kligfield P. Heart rate adjustment of exercise-induced ST segment depression: improved risk stratification in the Framingham Offspring Study. Circulation. 1991;83:866-874.
19. Okin PM, Grandits G, Rautaharju PM, Prineas RJ, Cohen JD, Crow RS, Kligfield P. Prognostic value of heart rate adjustment of exercise-induced ST segment depression in the Multiple Risk Factor Intervention Trial. J Am Coll Cardiol. 1996;27:1437-1443.
20. Detry JMR, Robert A, Luwaert RJ, Rousseau MF, Brasseur LA, Melin JA, Brohet CR. Diagnostic value of computerized exercise testing in men without previous myocardial infarction: a multivariate, compartmental and probabilistic approach. Eur Heart J. 1985; 6:227-238.
21. Detrano R, Salcedo E, Passalacqua M, Friis R. Exercise electrocardiographic variables: a critical appraisal. J Am Coll Cardiol. 1986;8:836-847.
22. Deckers JW, Rensing BJ, Tijssen JG, Vinke RVH, Azar AJ, Simoons ML. A comparison of methods of analysing exercise tests for diagnosis of coronary artery disease. Br Heart J. 1989;62: 438-444.
23. Robert AR, Melin JA, Detry JMR. Logistic discriminant analysis improves diagnostic accuracy of exercise testing for coronary artery disease in women. Circulation. 1991;83:1202-1209.
24. Okin PM, Kligfield P, Ameisen O, Goldberg H, Borer JS. Identification of anatomically extensive coronary artery disease by the exercise ECG ST segment/heart rate slope. Am Heart J. 1988;115: 1002-1013.
25. Okin PM, Kligfield P, Milner MR, Goldstein SA, Lindsay J Jr. Heart rate adjustment of ST-segment depression for reduction of false positive electrocardiographic responses to exercise in asymptomatic men screened for coronary artery disease. Am J Cardiol. 1988;62:1043-1047.
26. Kligfield P, Ameisen O, Okin PM. Heart rate adjustment of ST segment depression for improved detection of coronary artery disease. Circulation. 1989;79:245-255.
27. Okin PM, Ameisen O, Kligfield P. Recovery-phase patterns of ST segment depression in the heart rate domain: identification of coronary artery disease by the rate-recovery loop. Circulation. 1989; 80:533-541.
28. Okin PM, Kligfield P. Gender-specific criteria and performance of the exercise electrocardiogram. Circulation. 1995;92:1209-1216.
29. Multiple Risk Factor Intervention Trial Research Group. Exercise electrocardiogram and coronary heart disease mortality in the Multiple Risk Factor Intervention Trial. Am J Cardiol. 1985;55: 16-24.
30. The Multiple Risk Factor Intervention Trial Group. Statistical design considerations in the NHLBI Multiple Risk Factor Intervention Trial (MRFIT). J Chronic Dis. 1977;30:261-275.
31. The Multiple Risk Factor Intervention Trial Research Group. Mortality rates after 10.5 years for participants in the Multiple Risk Factor Intervention Trial: findings related to a priori hypotheses of the trial. JAMA. 1990;263:1795-1801.
32. Multiple Risk Factor Intervention Trial Research Group. Baseline rest electrocardiographic abnormalities, antihypertensive treatment, and mortality in the Multiple Risk Factor Intervention Trial Am J Cardiol. 1985;55:1-15.
33. Mason RE, Likar I. A new system of multiple-lead exercise electrocardiography.Am Heart J. 1966;71:196-205.
34. Goldschlager N, Selzer A, Cohn K. Treadmill stress tests as indicators of presence and severity of coronary artery disease. Ann Intern Med. 1976;85:277-286.
35. Morris JA, Gardner MJ. Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. Br Med J. (Clin Res Ed). 1988;296:1313-1316.
36. Kaplan E, Meier P. Non-parametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457-481.
37. Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep. 1966; 50:163-170.
38. Cox DR. Regression models and life tables. J R Stat Soc. 1972; 34(series B):187-220.
39. Kalbfleisch JD, Prentice RL. The Statistical Analysis of Failure Time Data. New York, NY: John Wiley & Sons Inc; 1980:101-103, 199-201.
40. Machin D, Gardner MJ. Calculating confidence intervals for survival time analyses. Br Med J. (Clin Res Ed). 1988;296:1369-1371.
41. Okin PM, Bergman G, Kligfield P. Heart rate adjustment of the time-voltage ST segment integral: identification of coronary disease and relationship to standard and heart rate adjusted ST segment depression criteria. J Am Coll Cardiol. 1991;18:1487-1492.
42. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med. 1990;322:1561-1566.
43. Koren MJ, Devereux RB, Casale PN, Savage DD, Laragh JH. Relation of left ventricular mass and geometry to morbidity and mortality in men and women with uncomplicated essential hypertension. Ann Intern Med. 1991;114:345-352.