Correlation of Duke's treadmill score with gated myocardial perfusion imaging in patients referred for chest pain evaluation.

Objective: To determine the correlation of Duke treadmill score (DTS) with gated single photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) in patients evaluated for chest pain.

Methods: A retrospective study was conducted at Tabba Heart institute. Two hundred consecutive patients, referred to the nuclear cardiology laboratory for evaluation of chest pain by using stress myocardial perfusion imaging (MPI) from January 2008 to August 2008 were included. Duke Treadmill Score (DTS) was calculated after exercise testing and categorized as low, moderate and high DTS groups. Subsequent gated SPECT-MPI was performed and stratified according to severity of perfusion defect. Spearmans rho (non parametric test) was applied to determine the correlation between DTS and SPECT-MPI RESULTS: The overall result showed positive linear correlation between DTS and MPI (p = < 0.001). Out of 200 patients, 136 (68%) had low DTS, 51 (25.5%) had moderate and 13 (6.5%) had high DTS respectively. In low DTS group 129 (95%) patients had low risk MPI and 7 (5%) had intermediate risk MPI. In moderate risk DTS group 25 (49%) had low risk MPI whereas 15 (29.5%) and 11 (21.5%) had intermediate and high risk MPI respectively. In high DTS group all 13 patients had high risk MPI.

Conclusions: On the basis of our findings it can be hypothesized that patients with high DTS can be referred for coronary angiography without imaging and patients with low DTS can be followed on medical management. However for definite conclusion diagnostic accuracy needs to be determine in further studies.