2015


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2015/№3

On changed sensitivity and specificity of instrumental examination methods in patients with ischemic heart disease in the setting of current pharmacotherapy

Tsokolov A. V.1, Vertiolkin A. V.1, Starikov V. N.1, Fisun A. Ya.2, Patlay I. I.3
1 – Federal State Governmental Institution, “1409 Naval Clinical Hospital of the Baltic Fleet” at the RF Ministry of Defense, Gertsena 2, Kaliningrad 236009
2 – “Central Military Medicine Administration“ of the RF Ministry of Defense Znamenka 19, Moscow 119160
3 – Federal State Budgetary Institution, “Federal Center of Cardiovascular Surgery” at the RF Ministry of Health Care, Kaliningradskoe Shosse 4, Settlement Rodniki, Gurjev District, Kaliningrad Region

Keywords: diagnostics, CAD, coronary angiography, ECG

DOI: 10.18087/rhj.2015.3.2060

Background. Progress in pharmacotherapy changes effectiveness of diagnostic methods. Aim. To elucidate causes for inconsistent diagnostic values (sensitivity, specificity) of ECG methods that were described as instruments for studying IHD patients in the 20th century and are used now. Materials and methods. The study included 115 patients (mean age, 61.2±8.6). A veloergometric test (VEMT) or Holter ECG monitoring were performed and followed by coronary angiography within the next month. Results. Percentage of coronary artery (CA) stenosis was from 31.3±32.3 % (for left CA) to 63.6±35 % (for right CA). ST segment depression >1 mm was observed in 31.3 % of cases whereas the true incidence of lesion in at least one CA (>50 %) was observed in 81.3 % of cases. The true sensitivity was 40.7 %, and specificity was 76.5 % for the VEMT and 38 % and 100 %, respectively, for the Holter ECG monitoring, which was lower than the values provided in available literature. Conclusion. Non-invasive methods, which allow reaching a submaximal heart rate, should be preferred keeping in mind that long-term treatment with modern medicines reduces the diagnostic value of the methods.
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Tsokolov A. V., Vertiolkin A. V., Starikov V. N. et al. On changed sensitivity and specificity of instrumental examination methods in patients with ischemic heart disease in the setting of current pharmacotherapy. Russian Heart Journal. 2015;14 (3):158–163

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