Duke Treadmill Score

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Clinical Use

Risk stratification for coronary artery disease and mortality based on exercise treadmill test

Formula

\[ DTS = Exercise Time \hspace{0.1cm}–\hspace{0.1cm} (5 \times Max ST) \hspace{0.1cm}–\hspace{0.1cm} (4 \times Angina) \]

More Info

The Duke Treadmill Score (DTS) is a point system to predict mortality and probability of coronary artery disease based on treadmill ECG stress testing.

Patients are categorized based on Duke treadmill score as follows:

DTSRisk category
>=+5Low risk
+4 to -10Moderate risk
<= -11High risk

 

Mortality risk and risk of coronary artery disease based one Duke Treadmill Category
DTS Risk Category1-Yr MortalityNo Stenosis >=75%1 VD >=75%2 VD >=75%3VD >=75% or LM >=75%
Men
Low0.9%52.6%22.4%13.6%11.4%
Mod2.9%17.8%15.6%27.9%38.7%
High8.3%1.8%9.1%17.5%71.5%
Women
Low0.5%80.9%9.4%6.2%3.5%
Mod1.1%65.1%14.2%8.3%12.4%
High1.8%10.8%18.9%24.3%46%
VD = Vessel Disease;  LM = Left Main

References

1.Mark DB, Hlatky MA, Harrell FE, Lee KL, Califf RM, Pryor DB. Exercise treadmill score for predicting prognosis in coronary artery disease. Ann Int Med 1987; 106:793-800. Full text
2.Mark DB, Shaw L, Harrell FE Jr., et al. Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. N Engl J Med 1991; 325:849-53. Full text
3.Alexander KP, Shaw L, Delong ER, Mark DB, Peterson ED. Value of exercise treadmill testing in women. J Am Coll Cardiol 1998; 32:1657-64. Full text

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Developer: Sirikarn Napan, MD, FACC