Joon Sup Lee, MD
To the Editors: In their recent paper, Miranda and colleagues (1) assert that ST-segment changes are more reliable markers of coronary artery disease than is exercise-induced angina. The validity of this conclusion relies, however, on the assumption that their study sample is representative of all patients undergoing exercise tests. Given the method in which the study sample was chosen, it is unlikely that this assumption is a valid one.
Of 3047 patients having exercise testing in their institution, only 30% had coronary angiography. Because this 30% was not selected at random for the purposes of this study, these patients might
Lee JS. Markers of Coronary Disease. Ann Intern Med. ;115:327–328. doi: 10.7326/0003-4819-115-4-327
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Published: Ann Intern Med. 1991;115(4):327-328.
Cardiology, Coronary Heart Disease.
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