Document Detail

Prediction of late cardiac events by dipyridamole thallium scintigraphy in patients with intermittent claudication and occult coronary artery disease.
MedLine Citation:
PMID:  8857474     Owner:  NLM     Status:  MEDLINE    
Concomitant coronary artery disease often occurs in patients with peripheral vascular disease, but it may be asymptomatic. Despite being asymptomatic, cardiovascular events are the main source of morbidity and mortality in this group of patients. Dipyridamole thallium scintigraphy has been shown to be of prognostic value in patients with peripheral vascular disease and symptomatic coronary artery disease, but its effect on the long-term outcome in the asymptomatic group of patients is less defined. Eighty-four consecutive patients with peripheral vascular disease and no symptoms of coronary artery disease were therefore evaluated by clinical assessment, dipyridamole thallium imaging, radionuclide ventriculography, and cardiac catheterization and followed for a mean of 66 months. Abnormal perfusion patterns were found on thallium scintigraphy in 48 patients (57%); fixed, mixed, and reversible defects were present in 14 (17%), 11 (13%), and 23 (27%) patients, respectively. Significant coronary artery disease was present in 52 patients (69%) and mean left ventricular ejection fraction was 44%. During the follow-up period, 23 patients had a cardiac event (nonfatal myocardial infarction or cardiac death). Univariate analysis of 15 clinical, scintigraphic, radionuclide, and angiographic variables revealed that age, angiographic extent of coronary artery disease, and an abnormal thallium scan were significant predictors of subsequent cardiac events. Multivariate stepwise logistic regression analyses selected fixed and mixed thallium defects and diffuse coronary artery disease as the only significant independent predictors of outcome. Thus, the present study shows the value of dipyridamole thallium scintigraphy as a valuable prognostic indicator for long-term event-free survival in a cohort of patients with peripheral vascular disease and no history or symptoms of coronary artery disease.
D Darbar; N Gillespie; G Main; A B Bridges; N S Kennedy; T H Pringle; G P McNeill
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  78     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-11-27     Completed Date:  1996-11-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  736-40     Citation Subset:  AIM; IM    
Department of Cardiology, Ninewells Hospital and Medical School, Dundee, Scotland.
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MeSH Terms
Coronary Disease / etiology,  radionuclide imaging*
Dipyridamole / diagnostic use
Follow-Up Studies
Heart Catheterization
Intermittent Claudication / complications*
Logistic Models
Middle Aged
Myocardial Infarction / etiology
Sensitivity and Specificity
Thallium Radioisotopes / diagnostic use
Reg. No./Substance:
0/Thallium Radioisotopes; 58-32-2/Dipyridamole

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

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