DTS Risk Stratification
| Score | Risk Category | Annual Mortality | Recommendation |
|---|
| ≥5 | Low | 0.25%/year | Medical therapy; consider no further testing |
| -10 to 4 | Moderate | 1.25%/year | Consider coronary angiography or imaging |
| ≤-11 | High | 5.25%/year | Coronary angiography recommended |
DTS = Exercise Duration (min) − (5 × Max ST Deviation, mm) − (4 × Angina Index)
Angina Index: 0=none, 1=non-limiting, 2=exercise-limiting
Clinical Notes:
• DTS validated for standard Bruce protocol; adjust interpretation for modified protocols
• High-risk DTS (≤-11): sensitivity 97% for severe CAD (3-vessel/left main)
• Not validated in pre-excitation (WPW), LBBB, paced rhythms, or digoxin use
• Combine with clinical pre-test probability (e.g., Duke Clinical Score)
