The Duke Treadmill Score (DTS) is a widely used prognostic tool in cardiology that integrates data from an exercise treadmill test (ETT) to provide a quantitative assessment of a patient’s likelihood of having significant coronary artery disease (CAD) and their risk for adverse cardiovascular events. Developed at Duke University in the 1980s, it has become one of the most established and validated tools in exercise testing.

The DTS is calculated from three main components: exercise duration (measured in minutes on the Bruce protocol), the degree of ST-segment deviation (in millimeters), and the presence or absence of angina during the test. Together, these values generate a numerical score that stratifies patients into low, intermediate, or high risk for significant CAD and cardiac mortality.

Clinicians use the DTS to guide patient management after a treadmill test. For example, patients with a low-risk score generally have excellent long-term survival and may not require additional invasive testing, while high-risk patients often need further imaging or coronary angiography. The intermediate group benefits from additional non-invasive evaluation.