angina have physiologically significant CAD which are at risk for developing into full–blown myocardial infarction or sudden death3. The clinical

value of exercise treadmill testing (TMT) has been well studied in these patients for early diagnosis4. But this test has low sensitivity and

specificity5.

Aim:The objective of this study is to analyze the coronary artery profile by conventional coronary angiogram (CAG) in patients with positive

exercise stress electrocardiogram.

Materials & methods: This is a prospective observational study conducted in the Institute of Cardiology, Madras Medical College & RGGGH,

Chennai from June 2016 – May 2017 on 117 TMT positive patients and who were subjected to CAG as per our institute protocol after excluding the

contraindications for the procedure11.

Results:Out of 117 TMT positive patients, 63% patients were male & 24 % were female with Mean age 53 ± 3 years. On diseased vessel analysis,

single vessel disease (SVD) was common with 27.4% followed by double vessel disease (DVD) (20.5%), triple vessel disease (TVD) (15.4%) and

at last 12.8% patients had left main involvement with or without involvement of other vessel. Diabetes emerges as a single predominant risk factor

for LMCA, TVD subgroups and hypertension is predominant DVD & SVD. Presence of more than one factor amplifies the risk.

Left main diseased showed poor functional capacity with termination of exercise less than 4 METS. ECG showed strong positive diffuse ST

changes with at earlier stages and angina was the limiting factor. TVD diseased developed above ST segment changes at later METS (4.0– 5.5) with

low function capacity. DVD diseased showed positive ST depression of average of 1.5mm with METS of 6.5 followed by SVD group patients

showed positive ST depression in later stages of exercise with METS around 8.0. Functional capacity was fair enough and breathlessness was the

limiting factor. TMT parameters are poor to predict branch vessel involvement. In women subgroup, premenopausal status is a protection against

CAD8. The emergence of risk factors like diabetes abolishes this protection and makes them vulnerable.

Conclusion:Treadmill test is effective in analyzing the patients with angina and its equivalent symptoms9. On amalgamation of clinical response,

exercise capacity with ST segment changes, TMT can be to predict the presence of proximal vessel lesion with focus on left main disease prior to

invasive coronary angiogram to certain extern7. TMT is ineffective for analyzing the branch vessel involvement and TMT has low predictive value

to diagnose CAD in premenopausal female patients.