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Studies find new value in overlooked heart-test results

heart test
Routine stress tests can indicate a risk of death from heart disease  

February 9, 1999
Web posted at: 10:49 p.m. EST (0349 GMT)

CHICAGO (CNN) -- Test results previously considered insignificant or inconclusive may be valuable in predicting the risk of death from heart disease, researchers said Tuesday.

Two new studies indicate that abnormalities spotted in inexpensive, routine stress tests -- but largely ignored -- can be significant indicators of risk.

"We found if these abnormalities existed, they increased the risk of a heart attack anywhere from 50 percent to 150 percent, meaning the risk would be increased from 1 1/2 to 2 1/2 times," said Dr. Philip Greenland of Northwestern University Medical School, referring to abnormalities in what doctors call the heart's ST-T wave.

The study that Greenland's team worked on found that minor ST-T readings are fairly common in electrocardiograms but were previously seen as being of uncertain importance in predicting future problems.

"Our findings suggest that recurrent nonspecific minor ST-T abnormalities on repeat examinations in middle-aged men indicate increased mortality risk and warrant especially vigorous preventative management," the study said.

The report was published in this week's Journal of the American Medical Association along with a second study from the Cleveland Clinic Foundation involving two other tests.

One covered exercise done during stress tests. The researchers said they found that a slower than expected heart rate in response to exercise or the inability to reach 85 percent of the age-adjusted maximum heart rate during exercise is an indicator of a greater risk of death.

Previously, the study said, inability to reach the target heart rate was seen as inconclusive.

"Now this study is showing the mere fact that they didn't reach 85 percent has a diagnostic implication in its own right, so we shouldn't just ignore it," said Dr. Basil Margolis of St. Joseph's Hospital in Atlanta.

The Cleveland researchers also said a test in which radioactive thallium is injected into a vein and travels to the heart, where it is absorbed by healthy heart muscle tissue but not by damaged tissue, is able to predict a higher risk of death.

Medical Correspondent Rhonda Rowland and Reuters contributed to this report.

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Northwestern University
JAMA - The Journal of the American Medical Association
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