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9DORUGLDJQyVWLFRGHORVSDUiPHWURV©PiVDOOiGHO67ªHQOD LQWHUSUHWDFLyQGHODSUXHEDGHHVIXHU]R 'LDJQRVWLFYDOXHRIWKH©EH\RQG67ªSDUDPHWHUVLQWKHVWUHVVWHVWLQWHUSUHWDWLRQ &ODUD 6DOGDUULDJD 0' *ORULD )UDQFR (SLGHPLyORJD &DUORV , (VFREDU 0' )UDQFLVFR ( /ySH] 0' 0DULR-DUDPLOOR0' /XLVD)'XUDQJR0' 'RULV&DVWDxHGD51 5LFDUGR)HUQiQGH]0' Medellín, Colombia. INTRODUCCIÓN: recientemente se han descrito nuevos parámetros y sistemas de puntaje que pretenden aumentar el valor diagnóstico y pronóstico de la prueba de esfuerzo, Este estudio tiene como objetivo describir la frecuencia de los parámetros más allá del ST en la población de pacientes que realizaron prueba de esfuerzo y calcular su valor diagnóstico adicional al rendimiento diagnóstico de la prueba con una población que realizó prueba de esfuerzo y coronariografía. METODOLOGÍA: estudio de validez de pruebas diagnósticas, en el que se calculó el rendimiento diagnóstico de los siguientes parámetros de la prueba de esfuerzo: MET alcanzados cuando la prueba se hace positiva, índice de Duke, doble producto y ajuste del ST según la frecuencia cardiaca, por medio del cálculo de sensibilidad y especificidad. RESULTADOS: se incluyeron 270 pacientes a quienes se les realizó prueba de esfuerzo y coronariografía, se calculó una sensibilidad de 70,74% y una especificidad de 46,34%, y posteriormente se realizó un nuevo análisis incluyendo los parámetros no ST (MET, índice ST/FC y doble producto) observando una mejoría en el rendimiento diagnóstico con una sensibilidad de 82,4% y especificidad 59,7%. CONCLUSIÓN: los parámetros más allá del ST constituyen una herramienta para la clasificación adecuada de falsos positivos y falsos negativos de la prueba de esfuerzo. PALABRAS CLAVE: prueba de esfuerzo, angiografía coronaria, enfermedad coronaria.
INTRODUCTION: new parameters and score systems have been described recently pretending to increase the diagnostic and prognostic value of the stress test. The objective of this study is to describe the frequency of these parameters beyond the ST in the population of patients who underwent stress test and coronary angiography, and to calculate its diagnostic value. METHODOLOGY: observational retrospective study in which the diagnostic performance of the following parameters of the stress test was calculated: MET obtained when the test becomes positive, Duke index, double product and ST adjustment according to the heart rate by the sensibility and specificity calculation.
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RESULTS: 270 patients that underwent stress test and coronary angiography were included. By means of a similar calculation to that of sensibility, named pseudo-sensibility (p sensibility) and pseudospecificity (p specificity), we calculated a sensibility of 70.74% and a specificity of 46.34%. A new analysis was further realized including non-ST parameters (METS, ST/HR index and double product), observing an improvement in diagnostic yield with a sensibility of 82.4% and a specifity of 59.7%. CONCLUSION: beyond ST parameters represent a main tool for the adequate classification of false positives and false negatives of the stress test. KEY WORDS: stress test, coronary angiography, coronary heart disease. 5HY&RORPE&DUGLRO
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Resultado de la prueba de esfuerzo Negativa
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