Abstract
BACKGROUND: Investigating the importance of exercise tolerance test (ETT) in the diagnosis of coronary artery disease (CAD) among people with left-sided dominant coronary circulation is very important. METHODS: This retrospective study aimed to explore the relevance of ETT in CAD diagnosis by analyzing medical records of 2084 patients who underwent ETT and coronary angiography in Urmia's educational therapeutic hospitals between 2018 and 2019. SPSS Version 16 was used for data analysis. RESULTS: The study included 5.58% males and 5.41% females. The prevalence of co-dominancy was 10.2%, right coronary dominance (RD) was 65%, and left coronary dominance (LD) was 24.8%. There were no significant differences between gender, age, smoking, blood pressure, diabetes mellitus (DM), the prevalence of hyperlipidemia (HLP), family history (FH) and left ventricular ejection fraction (LVEF). The frequency of non-significant CAD was higher in women than in men. Additionally, the frequency of women with LD was significantly higher than that of men. The results of angiography in normal cases, it was observed that the highest frequency was related to female patients with a history of DM. The sensitivity of the ETT was 94%, and the accuracy and diagnostic power of the exercise test for the presence of CAD in individuals with LD were 53% (p = 0.03). CONCLUSION: The study highlights the potential for false-positive exercise tests in diabetic individuals with left coronary dominance, providing valuable insights into the nuanced interplay of gender, cardiovascular health, and coronary circulation patterns in CAD risk.