Duke Treadmill Score

Duration of exercise (minute)

Maximal net ST-segment deviation During or after exercise and NOT in lead aVR (mm.)

Angina index

No angina during exercise (0)

Non-limiting angina (+1)

Patients stop exercising because of angina (+2)

The Duke Treadmill Score was originally developed based on the number of minutes of exercise performed using the Bruce protocol.

Duke Treadmill Score = [exercise duration in minutes, by Bruce protocol] – [ 5 × (maximal ST elevation or depression, in millimeters)] – [4 × (treadmill angina index)]

Duke treadmill scores typically range from -25 (indicating the highest risk) to +15 (indicating the lowest risk). The one-year mortality and five-year survival rates associated with these scores are as follows:

- A score of less than or equal to -11: 5.25% annual mortality rate.

- A score between -10 and 4: 1.25% annual mortality rate.

- A score of 5 or greater: 0.25% annual mortality rate.

Reference

Mark DB, Hlatky MA, Harrell FE Jr, Lee KL, Califf RM, Pryor DB. Exercise treadmill score for predicting prognosis in coronary artery disease. Ann Intern Med. 1987 Jun;106(6):793-800. doi: 10.7326/0003-4819-106-6-793.