Diagnostic Accuracy of Electrocardiography for Diagnosis of Coronary Artery Disease in Patients Undergoing Coronary Angiography

Abstract

Objective: To determine the diagnostic accuracy of electrocardiography for diagnosis of coronary artery disease taking coronary angiography as gold standard

Methodology: This Cross-sectional, validation research was conducted in the department of Cardiology, Punjab Institute of Cardiology, Lahore from August 2025 to January 2026. After obtaining informed consent and demographics, patients underwent ECG and findings were recorded. Cases were labeled as positive or negative for coronary artery disease if ECG was abnormal or normal, respectively. All patients then underwent coronary angiography. On coronary angiography, if >50% stenosis was present in one or more coronary artery, then it was confirmed as positive coronary artery disease. Data was noted in proforma and analyzed in SPSS v27.

Results: Mean age of enrolled cases 51.13 ± 11.84 years. There were 88 (55%) men and 72 (45%) women in whole sample. On angiography, there were 82 (51.25%) positive patients for CAD while 78 (48.75%) were negative. On coronary angiography, it has been observed that single vessel-disease was present in 52 (32.5%) cases, double vessel-disease in 65 (40.6%) cases and triple vessel-disease in 43 (26.9%) cases. By comparing findings of ECG with coronary angiography, it has been observed that ECG attained Sensitivity of 89.0%, Specificity of 69.2%, PPV of 75.3%, NPV of 85.7% and diagnostic accuracy of 79.4%.

Conclusion: It has been concluded that ECG can be a reliable tool for detection of coronary artery disease. Further researches are required to confirm evidence.