PROGNOSTIC VALUE OF DIPYRIDAMOLE-THALLIUM SCINTIGRAPHY IN PATIENTS WITH CORONARY-ARTERY DISEASE TREATED MEDICALLY

To evaluate the prognosis of patients with coronary artery disease treated medically using dipyridamole thallium scintigraphy, 277 consecutive patients were followed prospectively. During 2.8 +/- 1.8 years of follow-up, 21 patients experienced nonfatal myocardial infarction or died from cardiac causes. Stepwise discriminant analysis using clinical and angiographic variables revealed that the combination of ejection fraction, number of diseased vessels, previous myocardial infarction and left ventricular asynergic score was most statistically significant (chi-square=24, p=0.0001) in predicting events. After including scintigraphic findings, the analysis revealed that the combination of negative washout rate, ejection fraction, ST depression during dipyridamole loading, previous myocardial infarction, coronary artery narrowing of >90%, left ventricular asynergic score and number of diseased vessels (chi-square=39, p<0.0001) was the best predictor of events. These results indicate that the addition of dipyridamole thallium scintigraphic data to established angiographic markers can help better identify patients with coronary artery disease who are at high risk of cardiac events.