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The treadmill exercise test for diagnosing coronary artery disease (CAD) and risk stratification is used on a routine basis to allow physicians to assess patients and determine the most appropriate intervention. The American College of Cardiology and the American Heart Association have recommended the use of the Duke treadmill score to stratify patient risk. This score was developed using a population with a median age of 49 and few elderly participants. Because the elderly have a higher prevalence of CAD that, when present, tends to be more severe than it is in younger patients, it may not be possible to generalize the Duke treadmill score to the elderly. Kwok and colleagues examined Duke treadmill scores in elderly patients (age 75 or older) and hypothesized that it would be less effective in risk stratification in these patients than in the younger population.
Patients studied included all those who received an exercise thallium test at a tertiary care center and were 75 years of age or older at the time of the...