Dipyridamole thallium imaging may not be a reliable screening test for coronary artery disease in patients undergoing vascular surgery

Journal Article · Mon Jan 01 04:00:00 EST 1990 · Clinical Cardiology; (USA)

DOI:https://doi.org/10.1002/clc.4960130105· OSTI ID:6938711

Marwick, T H; Underwood, D A ^[1]

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1. Cleveland Clinic Foundation, OH (USA)

Dipyridamole thallium imaging has been proposed for cardiac risk stratification in patients undergoing peripheral vascular surgery. The purpose of this study was to define the benefit of this investigation in routine preoperative evaluation of these patients. The outcome of 86 patients undergoing vascular surgery procedures was examined in light of preoperative clinical assessment and dipyridamole SPECT thallium imaging (DST). Fifty-one patients (59%) were considered at high risk on clinical grounds, and 22 patients (26%) had perfusion defects. Ten patients suffered a perioperative coronary event, including unstable angina, myocardial infarction, or cardiac death. Seven of the patients with such events were among the 51 clinically high-risk subjects (14%). Three perioperative events occurred in the group of 19 patients with positive DST images who underwent surgery (16%), but the DST test failed to identify 7 patients who suffered coronary events. The frequency of abnormal thallium imaging was similar to the prevalence of angiographically significant coronary disease reported previously at this center, but considerably less than the rate of abnormal thallium imaging in past studies of vascular surgery patients. The application of the test to a low to moderate risk population is probably responsible for its lower predictive accuracy for coronary events. DST is not an ideal routine noninvasive technique for risk stratification in patients undergoing vascular surgery.

• OSTI ID: 6938711
• Journal Information: Clinical Cardiology; (USA), Journal Name: Clinical Cardiology; (USA) Vol. 13:1; ISSN 0160-9289; ISSN CLCAD
• Country of Publication: United States
• Language: English

Related Subjects

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550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ACCURACY
BLOOD VESSELS
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
EMISSION COMPUTED TOMOGRAPHY
ISOTOPES
MEDICINE
ORGANS
PATIENTS
RISK ASSESSMENT
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
SURGERY
THALLIUM ISOTOPES
TOMOGRAPHY
VASODILATORS