Document Detail


Predictive value of sequential testing in screening for silent myocardial ischemia in asymptomatic middle-aged men (the ECCIS Project).
MedLine Citation:
PMID:  8725321     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
D Antoniucci; F Seccareccia; A Menotti; P L Prati; F Rovelli; P F Fazzini
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiology     Volume:  87     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:    1996 May-Jun
Date Detail:
Created Date:  1996-10-01     Completed Date:  1996-10-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  240-3     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Ospedale di Careggi, Firenze, Italy.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Thallium Radioisotopes

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


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