Duke Treadmill Score
Enter the total exercise time on the Bruce protocol treadmill test (minutes), maximal ST-segment deviation (mm) and the angina index to stratify ischemic risk.
Total duration on Bruce protocol treadmill.
Maximum horizontal or downsloping ST depression/elevation.
How to Use This Calculator
Collect treadmill data
Document total exercise time (minutes), peak ST deviation (mm), and whether angina limited exercise.
Enter values
Input the metrics exactly as measured during the Bruce protocol treadmill test.
Interpret the score
Use the resulting risk category to guide need for further imaging, invasive evaluation, or conservative follow-up.
Formula
Duke Treadmill Score = Exercise time (minutes) − 5 × ST deviation (mm) − 4 × Angina index
Angina index: 0 = none, 1 = nonlimiting, 2 = exercise-limiting angina.
Low risk ≥ 5, intermediate risk −10 to +4, high risk ≤ −11.
Full Description
The Duke Treadmill Score integrates exercise duration, ST-segment changes, and angina to stratify mortality risk after treadmill stress testing. It aids decisions about coronary angiography, revascularisation, and the intensity of preventive therapy. Scores correlate with angiographic coronary disease severity and 5-year cardiovascular mortality.
Frequently Asked Questions
What if a patient stops due to fatigue without angina?
Use an angina index of 0. Noncardiac limiting symptoms do not increase the score.
Can I use protocols other than Bruce?
Yes, but convert exercise time to Bruce-equivalent METs or minutes for accuracy, or interpret qualitatively.
How should high-risk scores be managed?
High-risk (≤ −11) typically warrants coronary angiography and aggressive risk factor therapy unless contraindicated.
Does the score apply to pharmacologic stress?
No. This score is specific to exercise treadmill testing and does not apply to pharmacologic stress imaging.