| Predictive value of sequential testing in screening for silent myocardial ischemia in asymptomatic middle-aged men (the ECCIS Project). | |
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MedLine Citation:
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PMID: 8725321 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The accuracy of sequential testing in the noninvasive diagnosis of coronary artery disease has been established in the symptomatic clinical populations, while little is known about its value when applied to low prevalence groups, such as totally asymptomatic men. To evaluate the accuracy of noninvasive sequential testing in the diagnosis of silent myocardial ischemia, data were collected from exercise electrocardiogram, 201Tl perfusion scintigraphy and radionuclide angiography for 62 totally asymptomatic middle-aged men who underwent coronary arteriography because they were positive for two or more markers of myocardial ischemia as determined by a diagnostic screening of a nonbiased population consisting of 4,842 presumably healthy men aged 40-59 years (the ECCIS Project). The predictive value of serial testing procedures for significant coronary artery obstruction was 35%. Predictive values of an abnormal electrocardiogram associated with either an abnormal 201Tl scintigram, an abnormal isotopic ventriculography, or both were 33, 38 and 31%, respectively. In asymptomatic middle-aged men, there is at least a 50% likelihood that an abnormal radionuclide test is a false-positive result, and the positive predictive value is not enhanced by the concordance of an abnormal 201Tl scintigraphy with an abnormal isotopic ventriculography. Thus, the application of noninvasive sequential testing in screening for asymptomatic coronary artery disease is limited by its low predictive value in accordance with the Bayesian probability theory. |
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Authors:
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D Antoniucci; F Seccareccia; A Menotti; P L Prati; F Rovelli; P F Fazzini |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Cardiology Volume: 87 ISSN: 0008-6312 ISO Abbreviation: Cardiology Publication Date: 1996 May-Jun |
Date Detail:
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Created Date: 1996-10-01 Completed Date: 1996-10-01 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 240-3 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Ospedale di Careggi, Firenze, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Exercise Test Heart Function Tests* Humans Male Middle Aged Myocardial Ischemia / diagnosis*, radionuclide imaging Predictive Value of Tests Radionuclide Angiography Thallium Radioisotopes / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Thallium Radioisotopes |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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