The Role of Treadmill Stress Test (TMT) as A Non-Invasive Screening Tool for Detecting Significant CAD and Predicting Lesion Location
DOI:
https://doi.org/10.11594/jk-risk.06.1.6Keywords:
Treadmill Stress Test (TMT), Coroangiography, Coronary Artery DiseaseAbstract
Background: Coronary artery disease (CAD) remains the leading cause of morbidity and mortality worldwide, underscoring the need for early detection methods that are accurate, cost-effective, and applicable across all levels of healthcare. The Treadmill Stress Test (TMT) is one of the most commonly used and still relevant modalities, evaluating myocardial ischemia through ST-segment changes, exercise capacity, and physiological responses to physical stress. Although coronary CT angiography and stress echocardiography offer higher diagnostic accuracy, their cost, limited accessibility, and logistical demands, including human resources and operational expenses, make TMT a preferable initial screening tool, especially in low-to-intermediate risk populations. Specific ST-segment deviations in certain electrocardiogram (ECG) leads during TMT may also indicate the anatomical location of coronary artery lesions.
Objective: This review examines the role of TMT as a non-invasive screening tool for detecting significant coronary stenosis (≥50%) and evaluates its ability to predict lesion location within the major coronary arteries, based on studies comparing the diagnostic performance of TMT with invasive coronary angiography.
Conclusion: TMT demonstrates a high negative predictive value, up to 90%, for excluding significant CAD, making it an effective screening modality for low-to-intermediate risk individuals. Its sensitivity and specificity generally range from 60–75% and 70–85%, respectively, depending on patient characteristics and testing protocols. ST-segment patterns in anterior and inferior leads help predict the involvement of specific coronary vessels. Given its affordability, accessibility, and ability to provide functional and prognostic information, TMT remains a valuable and relevant screening tool in modern clinical cardiology.
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