Abstract
To determine whether clinical variables of coronary risk factors and electrocardiographic and scintigraphic findings could reliably detect the presence of coronary artery disease and of coronary stenosis in the individual coronary arteries, 11 clinical and 7 electrocardiographic and scintigraphic variables were compared with the findings of coronary angiography in 107 patients. Sixty-seven patients had angiographic evidence of coronary artery disease and forty did not. Exercise electrocardiograms were diagnostic in 43 patients (64%) and exercise thallium-201 scintigraphy in 56 (84%). A coronary scoring using all the above variables based on multiple discriminant analysis increased the diagnostic accuracy (sensitivity 96% and specificity 95%). This scoring system was applied to a prospective series of 59 cases with similarly selected patients. Fifty-five cases (93%) were correctly diagnosed. The coronary scoring system to assess the stenosis of individual arteries was less satisfactory and 51 cases (86%) of the right coronary, 51 (86%) of the left anterior descending and 44 (75%) of the left circumflex artery were accurately diagnosed. It is concluded that statistical multivariate analysis of clinical, electrocardiographic and scintigraphic variables facilitates the detection of coronary artery disease and that this scoring system is helpful assessing the probability of individual coronary artery involvement.
