The Predictive Value of Myocardial Perfusion Scintigraphy after Stress in Patients without Previous Myocardial Infarction

• Published in: The Journal of nuclear medicine (1978) Vol. 19; no. 3; pp. 249 - 255
• Main Authors: Turner, David A, Battle, William E, Deshmukh, Hanumant, Colandrea, Michael A, Snyder, Gary J, Fordham, Ernest W, Messer, Joseph V
• Format: Journal Article
• Language: English
• Published: United States Soc Nuclear Med 01.03.1978
• Subjects: Cineangiography; Coronary Angiography; Coronary Disease - diagnostic imaging; Exercise Test; Female; Humans; Male; Middle Aged; Radioisotopes; Radionuclide Imaging; Thallium
• ISSN: 0161-5505; 1535-5667

Seventy-five patients who had chest pain but no history or ECG evidence of myocardial infarction (MI) underwent myocardial-stress perfusion scintigraphy (MSPS) with thallium-201, treadmill-stress testing (TST), and coronary cineangiography (CA). The sensitivities of MSPS and TST for coronary stenosis greater than or equal to 75% were 68% and 71%, respectively; their specificities were 97% and 79%, respectively (0.1 greater than p greater than 0.05). When the character of a patient's chest pain is considered, Bayesian analysis leads to the following conclusions: (a) MSPS can be useful in pre-CA screening of patients with chest pain but no MI if their pain is thought to be of uncertain or nonischemic origin: (b) the sensitivity of Tl-201 MSPS is not sufficient for pre-CA screening of patients without MI who have typical or atypical angina pectoris; (c) the sensitivity of MSPS would have to be approximately 95% in order for the test to be useful in pre-CA screening of patients who have atypical angina pectoris; (d) MSPS may be superior to TST in these applications; and (e) it is not clear that there is any advantage in combining MSPS and TST into a single screening test rather than using MSPS alone.