Chest Pain with Normal Thallium-201 Myocardial Perfusion Image - Is It Really Normal?
نویسندگان
چکیده
BACKGROUND Thallium-201 myocardial perfusion image (MPI) is commonly used to detect coronary artery disease in patients with chest pain. Although a normal thallium-201 MPI result is generally considered to be a good prognosis and further coronary angiogram is not recommended, there are still a few patients who suffer from unexpected acute coronary events. The aim of this study was to investigate the clinical prognosis in patients with normal thallium-201 MPI. METHODS From January 2006 to August 2012, a total 22,003 patients undergoing thallium-201 MPI in one tertiary center were screened. Of these, 8092 patients had normal results and were investigated retrospectively. During follow-up, 54 patients underwent coronary angiogram because of refractory typical angina pectoris or unexpected acute coronary events. These 54 patients were divided into 2 groups: group I consisted of 26 (48.1%) patients with angiography-proven significant coronary artery stenosis, and group II consisted of 28 (51.9%) patients without significant stenosis. RESULTS Patients in group I had a higher prevalence of prior coronary stenting and electrocardiographic features of ST depression compared with patients in group II. The multivariate analysis demonstrated that both prior coronary stenting and ST depression were risk predictors of unexpected acute coronary events in the patients with normal thallium-201 MPI [odds ratio (OR), 5.93; 95% confidence interval (CI): 1.03-34.06, p = 0.05 and OR, 7.10; 95% CI: 1.28-39.51, p = 0.03,respectively]. CONCLUSIONS Although there is a low incidence of unexpected acute coronary events in patients with chest pain and normal thallium-201 MPI, physicians should be aware of the potentials risk in certain patients in this specific population.
منابع مشابه
Anginal chest pain in sarcoidosis.
Of 43 consecutive black patients (42 male) with sarcoidosis, 12 (28%) complained of chest pain that met the clinical criteria for typical (four patients) or atypical (eight patients) angina pectoris. These patients underwent cardiopulmonary assessment, which included exercise and redistribution thallium-201 scans and, if indicated, coronary angiography. Nine control patients with sarcoidosis ma...
متن کاملThallium-201 Myocardial Perfusion Imaging
The sensitivity of myocardial perfusion imaging (MPI) using thallium-201 injected both at rest and during peak exercise was compared to simultaneously recorded 12 lead electrocardiography (ECG) for the detection of transient ischemia in 20 normal subjects and 63 patients with coronary artery disease (CAD). No significant perfusion defects or ECG changes were seen on either the rest or exercise ...
متن کاملThe utility and potential cost-effectiveness of stress myocardial perfusion thallium SPECT imaging in hospitalized patients with chest pain and normal or non-diagnostic electrocardiogram.
BACKGROUND The evaluation of hospitalized patients with chest pain and non-diagnostic electrocardiogram is problematic and the optimal cost-effective strategy for their management controversial. OBJECTIVES To determine the utility of myocardial perfusion imaging with thallium-201 for predicting outcome of hospitalized patients with chest pain and a normal or non-diagnostic ECG. METHODS On p...
متن کاملPotential value of thallium-201 scintigraphy as a means of selecting patients for the coronary care unit.
The potential value of thallium-201 scintigraphy as a means of selecting patients for appropriate coronary care unit admission was evaluated. Studies were made prospectively on 203 patients with possible acute myocardial infarction but atypical history and non-diagnostic electrocardiogram at a time when the clinical diagnosis was still in doubt. Under conventional circumstances, this particular...
متن کاملNegative stress echocardiographic responses in normotensive and hypertensive patients with angina pectoris, positive exercise stress testing, and normal coronary arteriograms.
OBJECTIVES To systematically compare the results of dobutamine stress echocardiography in matched groups of hypertensive and normotensive patients with anginal chest pain and normal coronary arteriograms (CPNA). SETTING University hospital. SUBJECTS 33 patients with exertional anginal chest pain, a positive exercise stress ECG, and a completely normal coronary arteriogram; 17 had a history ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Acta Cardiologica Sinica
دوره 32 3 شماره
صفحات -
تاریخ انتشار 2016