Silent ischemia after coronary angioplasty: Evaluation of restenosis and extent of ischemia in asymptomatic patients by tomographic thallium-201 exercise imaging and comparison with symptomatic patients

Journal Article · Fri Mar 01 04:00:00 EST 1991 · Journal of the American College of Cardiology; (USA)

DOI:https://doi.org/10.1016/S0735-1097(10)80183-4· OSTI ID:6060089

Hecht, H S; Shaw, R E; Chin, H L; Ryan, C; Stertzer, S H; Myler, R K ^[1]

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1. San Francisco Heart Institute, Daly City, CA (USA)

One hundred sixteen patients were evaluated to determine the ability of single photon emission computed tomographic (SPECT) thallium-201 exercise and redistribution imaging to detect silent ischemia secondary to restenosis in asymptomatic patients after single and multiple vessel percutaneous transluminal coronary angioplasty and the findings were compared with SPECT imaging detection of restenosis in symptomatic patients. The value of exercise electrocardiography (ECG) and the amount of ischemic myocardium in symptomatic and asymptomatic patients were determined. Forty-one patients were asymptomatic after angioplasty; 77% of these had chest pain before angioplasty. Seventy-five patients had chest pain after angioplasty; 99% of these had chest pain before angioplasty. Restenosis occurred in 61% of asymptomatic and 59% of symptomatic patients and in 46% of the vessels in both asymptomatic and symptomatic patients. Sensitivity, specificity and accuracy for detection of restenosis by SPECT in individual patients were 96%, 75% and 88% versus 91%, 77% and 85%, respectively, in the asymptomatic versus symptomatic groups (p = NS). Sensitivity, specificity and accuracy for restenosis detection in individual vessels were 90%, 89% and 89% versus 84%, 77% and 84%, respectively, in the asymptomatic and symptomatic groups (p = NS), with similar results for the three major arteries. Sensitivity and accuracy of exercise ECG were significantly less than those of SPECT imaging for the patients with silent (40% and 44%) and symptomatic (59% and 64%) ischemia (p less than 0.001). Restenosis of vessels in the patients with silent and symptomatic ischemia was associated with an equal amount and degree of severity of ischemic myocardium in the two groups.

• OSTI ID: 6060089
• Journal Information: Journal of the American College of Cardiology; (USA), Journal Name: Journal of the American College of Cardiology; (USA) Vol. 17:3; ISSN 0735-1097; ISSN JACCD
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
CORONARIES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
EXERCISE
HEART
HEAVY NUCLEI
ISCHEMIA
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SENSITIVITY ANALYSIS
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
SPECIFICITY
THALLIUM 201
THALLIUM ISOTOPES
TOMOGRAPHY
VASCULAR DISEASES