Volume 24, Issue 101, January - February, 2020

Detecting probable coronary insufficiency in asymptomatic hypercholesterolemic individuals by treadmill exercise electrocardiography

Raed Dheyaa Jaafar

Cardiac surgical department of Ibn Al Bittar cardiac surgical center, Baghdad, Iraq; Email: dr.hayder@esraa.edu.iq

ABSTRACT

Objective: Assessment of the possible presence of silent coronary insufficiency (SMI) in hypercholesterolemic individuals who are not complaining of documented atherosclerotic disorders. Methods: A case – control study carried out in the outpatient’s clinic, biochemical laboratory, Alexandria University Hospital. All participants undergo ETT (exercise tolerance test). The study based on selection of patients with one major risk factor (serum cholesterol ≥250 mg/dl), without any additional risk factors (like DM, hypertension etc.). The study included 70 subjects, and were divided into two groups, group A (diagnosed with hypercholesterolemia) included 50 subjects (22 males, and 28 females), in which serum cholesterol ≥ 250 mg/dL. While group B (normal control), included 20 subjects (11 males, and 9 females) with serum cholesterol ≤200 mg/dL. Results: Only three cases (6%) showed positive finding after performing ETT (all were in group A), however, there was no significant difference in ETT between group A and B (p-value = 0.552). Conclusion: The value of exercise tolerance test was limited in assessing silent myocardial ischemia in hypercholesterolemic people, if they are free from multiple major cardiac risk factors and other conventional cardiac complaints. Due to high false positive results of the ETT in cases with a low pretest probability, it is not a reliable procedure to detect SMI in low suspicious cases.

Keywords: exercise tolerance, hypercholesterolemia, silent myocardial ischemia, major risk factor

Medical Science, 2020, 24(101), 301-307

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