Predicting Factors for a False Positive Treadmill Exercise Stress Test
Korakoth Towashiraporn MD*, Rungroj Krittayaphong MD*, Ahthit Yindeengam BSc**
Affiliation : * Division of Cardiology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Research Promotion, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : The present study was conducted to determine whether the exaggerated blood pressure (BP) response as well
as other factors during exercise stress test (EST) is associated with false positive treadmill EST.
Material and Method: This is a retrospective (case-control) study. Patient upon whom EST was performed at Her Majesty
Cardiac Center (HMCC), Siriraj Hospital, Mahidol University and for whom the result revealed positive EST and underwent
coronary angiogram (CAG) during October 2007-July 2011.
Results : 272 patients were included. 61% was male gender. There were 65 false positive cases (23.9%). Most patients are
female (60%). No significant difference in baseline systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart
rate (HR) was noted between true and false positive group. Using Multiple logistic regression analysis to determining the
independent predictors of false positive EST, exaggerated BP response did not result in false positive EST and factors that
were associated with the occurrence of false positive EST are female (OR 2.604, 95% CI 1.109-5.952, p = 0.018), the use of
statin (OR 0.402, 95% CI 0.194-0.835, p = 0.015), the difference between the peak and the baseline HR (OR 1.049, 95% CI
1.028-1.071, p < 0.001) and time from abnormal to baseline ECG (OR 0.725, 95% CI 0.641-0.820, p < 0.001).
Conclusion : The present study did not demonstrate that the exaggerated BP response during EST is associated with false
positive EST.
Keywords : False positive EST, Exaggerated blood pressure response
