Duke Treadmill Score: Provides prognostic information for patients with suspected CAD based on treadmill exercise results.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Prognostic stratification of patients with known or suspected coronary artery disease (CAD).
Evaluating survival and risk of future cardiac events post-exercise stress testing.
Section 2
Formula & Logic
Formula
Score = Exercise Time − (5 × ST deviation) − (4 × Angina Index)
Exercise Time in minutes (Bruce protocol).
ST deviation in millimeters.
Angina Index: 0 = none, 1 = non-limiting, 2 = exercise-limiting.
Interpretation (5-Year Survival)
Low Risk (≥ 5)
99% survival
Moderate Risk (−10 to +4)
95% survival
High Risk (< −10)
72% survival
Section 3
Pearls/Pitfalls
The Power of Exercise
The Duke Treadmill Score combines the major ischemia markers (ST change and angina) with the single most powerful prognostic marker in cardiology: exercise capacity.
Section 4
Next Steps
Complementary Calculators
ASCVD Risk Estimator
GRACE ACS Risk Score
SYNTAX Score
FFR Calculator
Cardiac Output Index
Section 5
Evidence Appraisal
Derivation Study
Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease.
Mark DB et al. • N Engl J Med.. 1991;325(12):849–53. Derived from 2,749 patients at Duke University.
