Predictive value of early maximal exercise test and thallium scintigraphy after successful percutaneous transluminal coronary angioplasty

Br Heart J. 1985 Feb;53(2):194-200. doi: 10.1136/hrt.53.2.194.

Abstract

Restenosis of the dilated vessel after percutaneous transluminal coronary angioplasty can be detected by non-invasive procedures but their ability to predict later restenosis soon after a successful angioplasty as well as recurrence of angina has not been assessed. A maximal exercise test and myocardial thallium perfusion scintigraphy were, therefore, performed in 91 asymptomatic patients a median of 5 weeks after they had undergone a technically successful angioplasty. Primary success of the procedure was confirmed by the decrease in percentage diameter stenosis from 64(12)% to 30(13)% as measured from the coronary angiograms and in the trans-stenotic pressure gradient (normalised for mean aortic pressure) from 0.61(0.16) to 0.17(0.09). A clinical follow up examination (8.6(4.9) months later) was carried out in all patients and a late coronary angiogram obtained in 77. The thallium perfusion scintigram showing the presence or absence of a reversible defect was highly predictive for restenosis whereas the exercise test was not. The positive predictive value of an abnormal scintigram was 82% compared with 60% for the exercise test (ST segment depression/or angina or both at peak workload). Angina or a new myocardial infarction occurred in 60% of patients with abnormal and in 21% of patients with normal scintigrams.

MeSH terms

  • Adult
  • Aged
  • Angina Pectoris / diagnosis
  • Angina Pectoris / therapy*
  • Angioplasty, Balloon*
  • Exercise Test*
  • Female
  • Follow-Up Studies
  • Heart / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Radioisotopes*
  • Radionuclide Imaging
  • Recurrence
  • Thallium*

Substances

  • Radioisotopes
  • Thallium