Document Detail


Exercise testing and electron beam computed tomography in the evaluation of coronary artery disease.
MedLine Citation:
PMID:  10898409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study compared coronary artery calcium (CC) as detected by electron beam computed tomography (EBCT) with conventional stress testing in the evaluation of patients with symptoms suggestive of coronary artery disease (CAD). BACKGROUND: Exercise electrocardiogram treadmill stress testing (treadmill-ECG) is limited by its requirement of a normal resting ECG and the ability of the patient to exercise adequately. The addition of myocardial imaging agents such as technetium improves the sensitivity and specificity but substantially increases the cost and prolongs the testing time. The use of EBCT provides a noninvasive and rapid method for identifying the presence and amount of CC, which has been shown to be related to atherosclerosis, and may provide additional information in combination with more traditional noninvasive testing methods. METHODS: A total of 97 patients underwent technetium stress testing (technetium-stress), treadmill-ECG, and EBCT coronary scanning within three months of coronary angiography for the evaluation of chest pain. RESULTS: The relative risk (RR) of obstructive angiographic CAD for an abnormal test was higher for EBCT (4.53) than either treadmill-ECG (1.72) or technetium-stress (1.96). The low specificity of EBCT (47%) was improved by the addition of treadmill-ECG (83%, p < 0.05). CONCLUSIONS: Electron beam computed tomography has a higher diagnostic ability than either treadmill-ECG or technetium-stress for the detection of obstructive angiographic CAD. Electron beam computed tomography is an accurate and noninvasive alternative to traditional stress testing for the detection of obstructive CAD in symptomatic patients.
Authors:
D M Shavelle; M J Budoff; D H LaMont; R M Shavelle; J M Kennedy; B H Brundage
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  36     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-08-01     Completed Date:  2000-08-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  32-8     Citation Subset:  AIM; IM    
Affiliation:
Saint John's Cardiovascular Research Center, Division of Cardiology, Harbor-UCLA Research and Education Institute, Torrance, California, USA. dshav@u.washington.edu.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Angiography
Coronary Disease / diagnosis*,  physiopathology
Coronary Vessels / radionuclide imaging
Diagnosis, Differential
Electrocardiography / methods*
Exercise Test*
Female
Humans
Injections, Intravenous
Male
Middle Aged
Prognosis
Radiopharmaceuticals / administration & dosage,  diagnostic use
Retrospective Studies
Sensitivity and Specificity
Technetium Tc 99m Sestamibi / administration & dosage,  diagnostic use
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2001 Jan;37(1):335-6; author reply 336-7   [PMID:  11153767 ]
J Am Coll Cardiol. 2001 Jan;37(1):334-5; author reply 336-7   [PMID:  11153766 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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