PREDICTIVE VALUE OF MYOCARDIAL PERFUSION SCINTIGRAPHY AFTER STRESS IN PATIENTS WITHOUT PREVIOUS MYOCARDIAL-INFARCTION

Abstract

Patients (75) who had chest pain but no history or ECG evidence of myocardial infarction (MI) underwent myocardial-stress perfusion scintigraphy (MSPS) with 201Tl, treadmill-stress testing (TST) and coronary cineangiography (CA). Sensitivities of MSPS and TST for coronary stenosis .gtoreq. 75% were 68% and 71%, respectively; their specificities were 97% and 79%, respectively (0.1 > P > 0.05). MSPS apparently was 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. Sensitivity of 201Tl MSPS was not sufficient for pre-CA screening of patients without MI who have typical or atypical angina pectoris. Sensitivity of MSPS must be approximately 95% in order for the test to be useful in pre-CA screening of patients who have atypical angina pectoris. MSPS may be superior to TST in these applications. It was not clear that there is any advantage in combining MSPS and TST into a single screening test rather than using MSPS alone.