The value of the Duke Activity Status Index (DASI) in predicting ischaemia in myocardial perfusion scintigraphy - a prospective study.

BACKGROUND Functional capacity assessment may be a useful tool to stratify patients according to risk of coronary artery disease (CAD). The Duke Activity Status Index (DASI) is a functional assessment based on activities of daily living and cardiovascular fitness, assessed using a self-administered questionnaire. MATERIAL AND METHODS We assessed the relationship between established clinical risk factors for CAD and the DASI with results of myocardial perfusion scintigraphy (MPS). The MPS results used in the analysis were the presence of reversible ischaemia and the resting left ventricular ejection fraction (LVEF). A DASI self-administered questionnaire was completed by 117 consecutive participants, and a patient history was taken to ascertain established risk factors. All participants underwent a stress test, and myocardial perfusion scintigraphy was performed. Statistical analysis consisted of logistic and linear regression using a statistical software package. RESULTS The DASI was the only factor that correlated significantly with reversible ischaemia on MPS. None of the previously established risk factors had a significant association with reversible ischaemia within the model. Our study found a potential relationship between the DASI score and the left ventricular ejection fraction (LVEF) although this was not statistically significant. CONCLUSIONS Our study findings suggest that the DASI may represent a powerful tool for risk stratification prior to investigation of CAD. A further study with a larger sample size will be required to investigate the predictive value of the DASI and the association with LVEF.