[Exercise stress testing and primary prevention]

Abstract

The detection of coronary artery disease is a major objective in public health. Over the last twenty years, much effort has been put into the development of investigations to detect coronary artery disease at an infra-clinical stage of which exercise stress testing is the most documented. However, it has never been possible to formally confirm the benefits of this test, or of any of the others, in the detection of silent coronary artery disease. The aim of this article is to summarise the current state of our scientific knowledge about the diagnostic and prognostic performances in primary prevention and to analyse how this investigation may be useful in asymptomatic patients. The authors particularly address the three following questions: 1) Does exercise stress testing improve the quality of primary prevention and the prognosis? 2) Does exercise stress testing detect a silent coronary lesion? And 3) does exercise stress testing improve risk evaluation in the asymptomatic patient?