This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (56)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Jeffrey M. Wahl; A-Hamid Hakki, MD; Abdulmassih S. Iskandrian, MD

Arch Intern Med. 1985;145(2):253-256.

Abstract
• We studied 455 patients (mean age, 51 years) in whom exercise thallium 201 scintigrams performed for suspected coronary artery disease were normal. Of those, 322 (71%) had typical or atypical angina pectoris and 68% achieved 85% or more maximal predicted heart rate. The exercise ECGs were abnormal in 68 patients (15%), normal in 229 (50%), and inconclusive in 158 (35%). Ventricular arrhythmias occurred during exercise in 194 patients (43%). After a mean follow-up period of 14 months, four patients had had cardiac events, sudden cardiac death in one and nonfatal myocardial infarctions in three. None of the four patients had abnormal exercise ECGs. Two had typical and two had atypical angina pectoris. Normal exercise thallium 201 images identify patients at a low risk for future cardiac events (0.8% per year), patients with abnormal exercise ECGs but normal thallium images have good prognoses, and exercise thallium 201 imaging is a better prognostic predictor than treadmill exercise testing alone, because of the high incidence of inconclusive exercise ECGs and the good prognosis in patients with abnormal exercise ECGs.

(Arch Intern Med 1985;145:253-256)

Author Affiliations
From the Likoff Cardiovascular Institute, Hahnemann University and Hospital, Philadelphia.

Footnotes
Accepted for publication June 20, 1984.

Read in part at the 31st annual meeting of the Society of Nuclear Medicine, Los Angeles, June 7, 1984.

Reprint requests to Likoff Cardiovascular Institute, Hahnemann University Hospital, 230 N Broad St, Philadelphia, PA 19102 (Dr Iskandrian).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Percutaneous Coronary Intervention for Stable Coronary Artery Disease
Katritsis and Meier
J Am Coll Cardiol 2008;52:889-893.
ABSTRACT | FULL TEXT  

Role of myocardial perfusion imaging for risk stratification in suspected or known coronary artery disease
Sabharwal and Lahiri
Heart 2003;89:1291-1297.
ABSTRACT | FULL TEXT  

Prognostic Value of Myocardial Perfusion Imaging in Patients With High Exercise Tolerance
Chatziioannou et al.
Circulation 1999;99:867-872.
ABSTRACT | FULL TEXT  

Nuclear Cardiology- First of Two Parts
Zaret and Wackers
NEJM 1993;329:775-783.
FULL TEXT  

Risk Stratification in Coronary Disease: A Contrary Viewpoint
Bodenheimer
ANN INTERN MED 1992;116:927-936.
ABSTRACT  

Exercise Thallium-201 Scintigraphy in the Diagnosis and Prognosis of Coronary Artery Disease
Kotler and Diamond
ANN INTERN MED 1990;113:684-702.
ABSTRACT  

The Single-cutoff Trap: Implications for Bayesian Analysis of Stress Electrocardiograms
Young et al.
Med Decis Making 1989;9:176-180.
ABSTRACT  

Exercise Thallium Imaging in Patients With Diabetes Mellitus: Prognostic Implications
Felsher et al.
Arch Intern Med 1987;147:313-317.
ABSTRACT  

Exercise Thallium-201 Scintigraphy in Men With Nondiagnostic Exercise Electrocardiograms: Prognostic Implications
Iskandrian et al.
Arch Intern Med 1986;146:2189-2193.
ABSTRACT