Dipyridamole-thallium scanning in patients undergoing vascular surgery. Optimizing preoperative evaluation of cardiac risk

Journal Article · Fri Apr 24 00:00:00 EDT 1987 · JAMA, J. Am. Med. Assoc.; (United States)

DOI:https://doi.org/10.1001/jama.1987.03390160071029· OSTI ID:6791111

Eagle, K A; Singer, D E; Brewster, D C; Darling, R C; Mulley, A G; Boucher, C A

Dipyridamole-thallium imaging has been suggested as a method of preoperatively assessing cardiac risk in patients undergoing major surgery. To define more clearly its proper role in preoperative assessment, we prospectively evaluated 111 patients undergoing vascular surgery. In the first set of 61 patients, our data confirmed the value of preoperative dipyridamole-thallium scanning in identifying the patients who suffered postoperative ischemic events. Events occurred in eight of 18 patients with reversible defects on preoperative imaging, compared with no events in 43 patients with no thallium redistribution (confidence interval for the risk difference: 0.624, 0.256). The results also suggested that clinical factors might allow identification of a low-risk subset of patients. To test the hypothesis that patients with no evidence of congestive heart failure, angina, prior myocardial infarction, or diabetes do not require further preoperative testing, we evaluated an additional 50 patients having vascular procedures. None of the 23 without the clinical markers had untoward outcomes, while ten of 27 patients with one or more of these clinical markers suffered postoperative ischemic events (confidence interval for the risk difference: 0.592, 0.148). In the clinical high-risk subset, further risk stratification is achieved with dipyridamole-thallium scanning.

• Research Organization: Massachusetts General Hospital, Boston
• OSTI ID: 6791111
• Journal Information: JAMA, J. Am. Med. Assoc.; (United States), Vol. 16
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BLOOD VESSELS
RADIOISOTOPE SCANNING
ISCHEMIA
RISK ASSESSMENT
ALGORITHMS
AORTA
DIAGNOSIS
PATIENTS
RADIOISOTOPES
SURGERY
THALLIUM
VASODILATORS
ARTERIES
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DISEASES
DRUGS
ELEMENTS
ISOTOPES
MATHEMATICAL LOGIC
MEDICINE
METALS
ORGANS
VASCULAR DISEASES
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