The Duke Treadmill Score (DTS) is a weighted index combining treadmill exercise time using standard Bruce protocol, maximum net ST segment deviation (depression or elevation), and exercise-induced angina. It was developed to provide accurate diagnostic and prognostic information for the evaluation of patients with suspected coronary heart disease. The typical observed range of DTS is from -25 (highest risk) to +15 (lowest risk). A low DTS is actually better at excluding ischemic heart disease in women than men.
Exercise Time - (5 x Max ST) - (4 x Angina Index)
Treadmill exercise time
Maximum net ST deviation (except aVR)
Treadmill angina index
No angina during exercise
Exercise limited angina
Duke treadmill score
DTS Risk Category
No Stenosis >=75%
1 VD >=75%
2 VD >=75%
3VD >=75% or LM >=75%
VD = Vessel Disease; LM = Left Main References
Mark DB, Hlatky MA, Harrell FE, Lee KL, Califf RM, Pryor DB. Exercise treadmill score for predicting prognosis in coronary artery disease. Ann Int Med 1987; 106:793-800.
Mark DB, Shaw L, Harrell FE Jr., et al. Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. N Engl J Med 1991; 325:849-53.
Alexander KP, Shaw L, Delong ER, Mark DB, Peterson ED. Value of exercise treadmill testing in women. J Am Coll Cardiol 1998; 32:1657-64.
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