Prognostic utility of the exercise thallium-201 test in ambulatory patients with chest pain: comparison with cardiac catheterization
The goal of this study was to determine the prognostic utility of the exercise thallium-201 stress test in ambulatory patients with chest pain who were also referred for cardiac catheterization. Accordingly, 4 to 8 year (mean +/- 1SD, 4.6 +/- 2.6 years) follow-up data were obtained for all but one of 383 patients who underwent both exercise thallium-201 stress testing and cardiac catheterization from 1978 to 1981. Eighty-three patients had a revascularization procedure performed within 3 months of testing and were excluded from analysis. Of the remaining 299 patients, 210 had no events and 89 had events (41 deaths, nine nonfatal myocardial infarctions, and 39 revascularization procedures greater than or equal to 3 months after testing). When all clinical, exercise, thallium-201, and catheterization variables were analyzed by Cox regression analysis, the number of diseased vessels (when defined as greater than or equal to 50% luminal diameter narrowing) was the single most important predictor of future cardiac events (chi 2 = 38.1) followed by the number of segments demonstrating redistribution on delayed thallium-201 images (chi 2 = 16.3), except in the case of nonfatal myocardial infarction, for which redistribution was the most important predictor of future events. When coronary artery disease was defined as 70% or greater luminal diameter narrowing, the number of diseased vessels significantly (p less than .01) lost its power to predict events (chi 2 = 14.5). Other variables found to independently predict future events included change in heart rate from rest to exercise (chi 2 = 13.0), ST segment depression on exercise (chi 2 = 13.0), occurrence of ventricular arrhythmias on exercise (chi 2 = 5.9), and beta-blocker therapy (chi 2 = 4.3).
- Research Organization:
- Univ. of Virginia School of Medicine, Charlottesville (USA)
- OSTI ID:
- 7253173
- Journal Information:
- Circulation; (United States), Vol. 77:4
- Country of Publication:
- United States
- Language:
- English
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CARDIOVASCULAR DISEASES
DIAGNOSIS
HEART
RADIOISOTOPE SCANNING
COMPARATIVE EVALUATIONS
EXERCISE
PATIENTS
REGRESSION ANALYSIS
THALLIUM 201
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MATHEMATICS
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
STATISTICS
THALLIUM ISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics