Duke Treadmill Score Explained

Duke Treadmill Score
Purpose:	predicting the risk of ischemia or infarction

Duke Treadmill Score is one of the tools for predicting the risk of ischemia or infarction in the heart muscle.^[1] The calculation is done based on the information obtained from an exercise test by this formula:

[exercise duration by [[Bruce protocol]]] - [5 × (maximal [[ST elevation]] or depression)] - [4 × (treadmill angina index)]

In which, the exercise duration is written in "minutes" and the ST changes in "millimetres".^[1] Angina index will be zero if no pain appears during the exercise, one if the pain is limited to the exercise period but the patient can continue the exercise (typical angina), and two if a limiting pain occurs which is a reason to stop the exercise test.^{[2] [3]}

Duke treadmill scores typically range from -25 (highest risk) to +15 (lowest risk). One-year mortality and five-year survival rates respectively for the results of the Duke treadmill score have been reported as:^{[4] [5] [6]}

less or equal to -11: 5.25% / 65%

4 to -10: 1.25% / 90%

more or equal to 5: 0.25% / 97%

Further reading

• 10.1016/S0735-1097(02)01769-2 . 11985910 . Prognostic value of the Duke treadmill score in the elderly . Journal of the American College of Cardiology . 39 . 9 . 1475–1481 . 2002 . Kwok . Jennifer M.F . Miller . Todd D . Hodge . David O . Gibbons . Raymond J .
• 10.1016/j.amjcard.2005.03.078. 16054460. Prognostic Value of the Duke Treadmill Score in Asymptomatic Women. The American Journal of Cardiology. 96. 3. 369–375. 2005. Gulati. Martha. Martha Gulati. Arnsdorf. Morton F. Shaw. Leslee J. Pandey. Dilip K. Thisted. Ronald A. Lauderdale. Diane S. Wicklund. Roxanne H. Al-Hani. Arfan J. Black. Henry R.
• 10.1016/S0002-9149(99)00565-2 . 10614798 . Long-term prognostic value of duke treadmill score and exercise thallium-201 imaging performed one to three years after percutaneous transluminal coronary angioplasty . The American Journal of Cardiology . 84 . 11 . 1323–1327 . 1999 . Ho . Kheng-Thye . Miller . Todd D . Holmes . David R . Hodge . David O . Gibbons . Raymond J .
• 15632026 . Prediction of death and nonfatal myocardial infarction in high-risk patients: A comparison between the Duke treadmill score, peak exercise radionuclide angiography, and SPECT perfusion imaging . 2005 . Liao . L . Journal of Nuclear Medicine. 46 . 1 . 5–11 . Smith Wt . 4th . Tuttle . R. H . Shaw . L. K . Coleman . R. E . Borges-Neto . S .
• 10.1016/j.ahj.2004.09.058 . 16169334 . Prognostic value of the Duke Treadmill Score in diabetic patients . American Heart Journal . 150 . 3 . 516–521 . 2005 . Lakkireddy . Dhanunjaya R . Bhakkad . Jyothi . Korlakunta . Hema L . Ryschon . Kay . Shen . Xuedong . Mooss . Aryan N . Mohiuddin . Syed M .
• 10.1016/j.ahj.2006.03.015 . 16781248 . Comparison of exercise echocardiography and the Duke treadmill score for risk stratification in patients with known or suspected coronary artery disease and normal resting electrocardiogram . American Heart Journal . 151 . 6 . 1324.e1–1324.e10 . 2006 . Peteiro . Jesús . Monserrrat . Lorenzo . Piñeiro . Miriam . Calviño . Ramon . Vazquez . Jose Manuel . Mariñas . Javier . Castro-Beiras . Alfonso .
• 10.1016/j.ijcard.2003.11.045 . 15708171 . Relation between Duke treadmill score and coronary flow reserve using transesophageal Doppler echocardiography in patients with microvascular angina . International Journal of Cardiology . 98 . 3 . 403–408 . 2005 . Youn . Ho-Joong . Park . Chul-Soo . Moon . Keon-Woong . Oh . Yong-Seok . Chung . Wook-Sung . Kim . Jae-Hyung . Choi . Kyu-Bo . Hong . Soon-Jo .
• 10.1016/j.amjcard.2008.07.020 . 18993164 . Age and Double Product (Systolic Blood Pressure × Heart Rate) Reserve-Adjusted Modification of the Duke Treadmill Score Nomogram in Men . The American Journal of Cardiology . 102 . 10 . 1407–1412 . 2008 . Sadrzadeh Rafie . Amir H . Dewey . Frederick E . Sungar . Gannon W . Ashley . Euan A . Hadley . David . Myers . Jonathan . Froelicher . Victor F .
• 10.1056/NEJM199109193251204 . 1875969 . Prognostic Value of a Treadmill Exercise Score in Outpatients with Suspected Coronary Artery Disease . New England Journal of Medicine . 325 . 12 . 849–853 . 1991 . Mark . Daniel B . Shaw . Linda . Harrell . Frank E . Hlatky . Mark A . Lee . Kerry L . Bengtson . James R . McCants . Charles B . Califf . Robert M . Pryor . David B . free .

Notes and References

1. Book: Ann Marie . Alessi . Exercise Stress Testing . 109–18 . . 2010 . Nuclear Cardiology Technology Study Guide (Voice). 9780932004833 .
2. Web site: [{{Google books|jyy7rceM4awC|page=172|plainurl=yes}} Duke Treadmill Score ]. 172 . in Book: 10.1007/978-0-387-76597-6_9 . Stratifying Symptomatic Patients Using the Exercise Test and Other Tools . Exercise Stress Testing for Primary Care and Sports Medicine . 167–192 . 2009 . White . Russell D . Goldschlager . Nora . 978-0-387-76596-9 .
3. 10.1016/j.amjcard.2008.07.020 . 18993164 . Age and Double Product (Systolic Blood Pressure × Heart Rate) Reserve-Adjusted Modification of the Duke Treadmill Score Nomogram in Men . The American Journal of Cardiology . 102 . 10 . 1407–1412 . 2008 . Sadrzadeh Rafie . Amir H . Dewey . Frederick E . Sungar . Gannon W . Ashley . Euan A . Hadley . David . Myers . Jonathan . Froelicher . Victor F .
4. Book: Management of Patients With Chronic Stable Angina. March 2003. ACC/AHA Pocket Guideline. 49.
5. Web site: Duke Treadmill Score Calculator.
6. News: Peter . Antoz . Treadmills . 4 August 2021.