Duke Treadmill Score
Predicts cardiovascular mortality risk from exercise stress testing. Score = Exercise time (min) − (5 × ST deviation mm) − (4 × Angina index).
Score interpretation
Duke Treadmill Score ≥ +5: < 1% annual cardiovascular mortality. 5-year survival ~99%.
→ Low risk. Medical management. No urgent further investigation unless symptoms change.
Duke Treadmill Score −10 to +4: ~1–4% annual cardiovascular mortality.
→ Further evaluation. Consider stress echo, nuclear perfusion, or coronary angiography.
Duke Treadmill Score < −10: > 4% annual cardiovascular mortality. 5-year survival ~72%.
→ High-risk. Early coronary angiography and revascularisation assessment.
Interpretation bands for the Duke Treadmill. Apply clinical judgement and local guidance.
References
- Mark DB et al. Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. N Engl J Med. 1991;325(12):849-853.
Related
Curated clinical cross-links plus same-class fallbacks.
- DAPT Score · Coronary Artery Disease
- Mehran Score for Post-PCI Contrast Nephropathy · Coronary Artery Disease
- Canadian Cardiovascular Society (CCS) Angina Grading · Coronary Artery Disease
- ARC-HBR Criteria for High Bleeding Risk in PCI · Coronary Artery Disease
- PRECISE-DAPT Score for Bleeding on DAPT · Coronary Artery Disease
- SYNTAX Score for Coronary Artery Disease · Coronary Artery Disease
- Hydrocortisone (ICU — Stress Dosing) · Corticosteroid (ICU/Septic Shock)
- Isosorbide Mononitrate (Stable Angina) · Nitrate / Stable Angina
- Nicorandil · Stable Angina
- Ranolazine · Refractory Stable Angina
- Colchicine (Pericarditis / Post-MI Inflammation) · Pericarditis / Coronary Inflammation
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.