Prognostic significance of normal quantitative planar thallium-201 stress scintigraphy in patients with chest pain
FJ Wackers,
DJ Russo,
D Russo,
and
JP Clements
The prognostic significance of normal quantitative planar thallium-201 stress scintigraphy was evaluated in patients with a chest pain syndrome. The prevalence of cardiac events during follow-up was related to the pretest (that is, before stress scintigraphy) likelihood of coronary artery disease determined on the basis of symptoms, age, sex and stress electrocardiography. In a consecutive series of 344 patients who had adequate thallium-201 stress scintigrams, 95 had unequivocally normal studies by quantitative analysis. The pretest likelihood of coronary artery disease in the 95 patients had a bimodal distribution. During a mean follow-up period of 22 +/- 3 months, no patient died. Three patients (3%) had a cardiac event: two of these patients (pretest likelihood of coronary artery disease 54 and 94%) had a nonfatal myocardial infarction 8 and 22 months, respectively, after stress scintigraphy, and one patient (pretest likelihood 98%) underwent percutaneous transluminal coronary angioplasty 16 months after stress scintigraphy for persisting anginal complaints. Three patients were lost to follow-up; all three had a low pretest likelihood of coronary artery disease. It is concluded that patients with chest pain and normal findings on quantitative thallium-201 scintigraphy have an excellent prognosis. Cardiac events are rare (infarction rate 1% per year) and occur in patients with a moderate to high pretest likelihood of coronary artery disease.
This article has been cited by other articles:
|
|
|
|
 
N K Sabharwal and A Lahiri
Role of myocardial perfusion imaging for risk stratification in suspected or known coronary artery disease
Heart,
November 1, 2003;
89(11):
1291 - 1297.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. L. Zaret and F. J. Wackers
Nuclear Cardiology- First of Two Parts
N. Engl. J. Med.,
September 9, 1993;
329(11):
775 - 783.
[Full Text]
|
|
|
|
|
|
|
A. J. Moss, R. E. Goldstein, W. J. Hall, J. T. Bigger Jr, J. L. Fleiss, H. Greenberg, M. Bodenheimer, R. J. Krone, F. I. Marcus, F. J. Th. Wackers, et al.
Detection and Significance of Myocardial Ischemia in Stable Patients After Recovery From an Acute Coronary Event
JAMA,
May 12, 1993;
269(18):
2379 - 2385.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. M. Bodenheimer
Risk Stratification in Coronary Disease: A Contrary Viewpoint
Ann Intern Med,
June 1, 1992;
116(11):
927 - 936.
[Abstract]
[PDF]
|
|
|
|
|
|
|
T. S. Kotler and G. A. Diamond
Exercise Thallium-201 Scintigraphy in the Diagnosis and Prognosis of Coronary Artery Disease
Ann Intern Med,
November 1, 1990;
113(9):
684 - 702.
[Abstract]
[PDF]
|
|
|
|
|
|
|
R. D. Hull, G. E. Raskob, C. J. Carter, G. Coates, G. J. Gill, D. L. Sackett, J. Hirsh, and M. Thompson
Pulmonary Embolism in Outpatients With Pleuritic Chest Pain
Arch Intern Med,
April 1, 1988;
148(4):
838 - 844.
[Abstract]
[PDF]
|
|
|
|
