Reliability of the exercise-induced ST-segment changes to detect restenosis three months after coronary angioplasty: Significance of the appearance in other leads,

Background Exercise-induced ST-segment changes 3 months after angioplasty may sometimes show a false-positive result. Methods We therefore analyzed the ST changes observed during the exercise tests performed before and 3 months after angioplasty in 118 patients with single-vessel coronary artery disease. Results Ninety-two (78%) of the 118 patients had ST changes in the same lead before and after angioplasty, whereas the remaining 26 (22%) patients had ST changes in other leads in the postangioplasty test when compared with the preangioplasty exercise test. Restenosis was found in 44 (48%) of the 92 patients with ST changes in the same lead but in only four (15%) of the 26 patients with ST changes in other leads. Conclusions Exercise-induced ST-segment changes are not reliable markers of restenosis 3 months after angioplasty. ST-segment changes observed in other leads after angioplasty compared with the preangioplasty exercise test may show a false-positive result. (Am Heart J 1998;135:449-56.)