BACKGROUND AND OBJECTIVES: The recent data has revealed that the first 1 minute and 2 minutes of heart rate recovery of patients who are being evaluated for chest pain and asymptomatic adults are associated with the overall mortality. However, the clinical significance of the heart rate recovery after exercise testing during the first 2 minutes for predicting the presence or severity of coronary artery disease and the correlation with the Duke treadmill score (DTS) have not been fully evaluated. SUBJECTS AND METHODS: The study population included 39 patients with significant coronary artery stenosis and 39 subjects with normal coronary arteries. All of them underwent a tread-mill exercise testing prior to coronary angiography. The differences in the heart rate recovery and the DTS between the two groups were investigated. The heart rate recovery and DTS between the multivessel disease group and single vessel disease group were also investigated. RESULTS: The heart rate recovery during the second minute (calculated by the heart rate at 1 minute-the heart rate at 2 minute) after exercise and the DTS were significantly lower in the coronary artery disease group. These parameters were also significantly lower in the multivessel disease group than those in the single vessel disease group. The heart rate recovery during the second minute and the DTS had positive linear correlation (R=0.281, p<0.05). CONCLUSION: In this study, the heart rate recovery during the second minute was considered to be an additional important variable to predict the presence and severity of coronary artery disease.