RESUMEN
While, the generally favorable prognosis of a normal exercise thallium scintigram is recognized, the impact of negative thallium scintigraphy in the presence of a positive exercise ECG is less well defined. Therefore, the incidence of subsequent cardiac events was evaluated in 235 consecutive patients with negative thallium scintigraphy and positive exercise ECG. Follow up [21 +/- 10 months] was available in 209 patients [89%], of these 79 patients [38%] had past clinical evidence of coronary artery disease. The clinical categorization of the remaining patients was uncertain. During follow up, 23 "hard" and "soft" cardiac events occurred, 1 cardiac death, 2 myocardial infarction, 5 coronary bypass grafting, 6 coronary angioplasty and 9 hospitalizations for cardiac reasons, of these 16 events including the 2 myocardial infarctions occurred in patients with clinical coronary artery [20% prevalence]. In contrast, only 7 events including the cardiac death occurred in the remaining clinically uncategorized patients [5.4% prevalence] P <0.002