Document Detail


Patients with adenosine-induced ST-segment depressions and normal myocardial perfusion imaging: cardiac outcomes at 24 months.
MedLine Citation:
PMID:  20535597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The significance of ischemic ECG changes during adenosine infusion in patients with normal myocardial perfusion imaging (MPI) is controversial. We evaluated the prevalence of, and defined the predictors for, severe coronary artery disease (CAD) in patients with such discordant findings.
METHODS: The findings of 3700 adenosine MPI studies performed at our institution between June 2005 and March 2009 were reviewed.
RESULTS: Data for 76 patients who had not previously undergone coronary revascularization and who had sufficient follow-up were analyzed; 22 (29%) were referred for coronary angiography and 10 (13%) underwent revascularization. None had left main disease and only three (14%) had multivessel disease. Diabetes mellitus was more prevalent (70% vs. 23%; P = .010) and ischemic ST-segment depressions more often lasted >5 minutes (50% vs. 15%; P = 0.021) in patients undergoing revascularization. During a 24 ± 13 month follow-up period, there were no deaths or myocardial infarctions, while an eleventh patient underwent revascularization 19 months after MPI.
CONCLUSIONS: In the presence of normal MPI, the specificity of ischemic ECG changes during adenosine infusion for the detection of severe obstructive CAD is poor, although patients with multiple coronary risk factors, particularly diabetes mellitus, should undergo further investigation.
Authors:
Jyoti Sharma; Christine Roncari; Kenneth N Giedd; John T Fox; Yumiko Kanei
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Publication Detail:
Type:  Journal Article     Date:  2010-06-10
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  17     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  874-80     Citation Subset:  IM    
Affiliation:
Department of Medicine, Beth Israel Medical Center, 1st Ave. at 16th St, 20th Floor Baird Hall, New York, NY 10003, USA. jsharma8@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adenosine / pharmacology*
Aged
Coronary Artery Disease / physiopathology,  radionuclide imaging
Electrocardiography / drug effects*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Perfusion Imaging*
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
58-61-7/Adenosine
Comments/Corrections
Comment In:
J Nucl Cardiol. 2010 Dec;17(6):1122; author reply 1123   [PMID:  20734179 ]

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


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