201Tl myocardial SPECT detects significant coronary artery disease between 50% and 75% angiogram stenosis.

UNLABELLED: Coronary angiography is the "gold standard" for the diagnosis of coronary artery disease (CAD). The aim of this work was to compare 201Thallium SPECT with different coronary angiographic cutoff values. METHODS: Data pertaining to 145 patients were tabulated. All patients underwent stress ECG, 201Thallium SPECT and coronary angiography. To assess the cutoff impact, two criteria for coronary angiography diagnosis were used: a) > or = 50% and b) > or = 75% stenosis, and applied to data from patients and vessels. RESULTS: On a patient basis, 201Thallium SPECT sensitivity, specificity and accuracy were 87%, 57% and 81% with > or = 50% cutoff and 93%, 51% and 79% with > or = 75% cutoff, respectively (NS). When performing individual vessel analysis, sensitivity, specificity and accuracy were 59%, 78% and 68% for > or = 50% cutoff and 70%, 75% and 74% for > or = 75% cutoff, respectively (p < 0.029 for sensitivity). As expected, the severer the stenosis the higher the detection rate. There were 19 patients who had stenosis between 50% and 74%. Of these, 21% had abnormal stress ECG and 58% abnormal Thallium-201 SPECT. CONCLUSION: 201Thallium SPECT results support the use of > or = 50% stenosis cutoff criteria for CAD diagnosis and evaluation. Combined with coronary angiography, myocardial SPECT offers an excellent management strategy to patients.

201Tl myocardial SPECT detects significant coronary artery disease between 50 % and 75 % angiogram stenosis

La angiografía coronaria es el estándar de oro para diagnosticar enfermedad coronaria. El objetivo de este trabajo fue comparar los resultados del SPECT con Talio 201 con los diversos valores de estenosis coronaria a la angiografía. Métodos: Se tabularon resultados de 145 pacientes. A todos ellos se les realizó una prueba de esfuerzo, SPECT de perfusión miocárdica con Talio 201 y angiografía coronaria. Para hacer la valoración se utilizaron 2 criterios angiográficos para estenosis coronaria: a) >= 50 % b) >= 75 %, los que se aplicaron a los pacientes y vasos coronarios estudiados por individual. Resultados: En una evaluación individual por paciente la sensibilidad (S), especificidad (E) y exactitud (Ex) fue de 87 %, 57 % y 81 % con criterio de estenosis de >= 50 % y de 93 %, 51 % y 79 % usando criterio de >= 75 %, respectivamente (NS). Al analizar los vasos individualmente la S, E y Ex fue de 59 %, 78 % y 68 % para criterio >= 50 % y 70 %, 75 % y 74 % para criterio >= 75 % (p < 0,029 para S). Como era esperado a mayor severidad de estenosis, mayor incidencia de detección. Hubo 19 pacientes que presentaron estenosis entre 50 y 74 %. De ellos 21 % presentó prueba de esfuerzo anormal y 58 % SPECT de perfusión miocárdica anormal. Conclusión: Los resultados con el estudio de perfusión miocárdica con Talio 201 avalan el uso del valor de 50 % o más de estenosis en el diagnóstico y evaluación de enfermedad coronaria. En conjunto con la angiografía coronaria el SPECT miocárdico ofrece una excelente estrategia para el manejo de los pacientes

Coronary angiography is the "gold standard" for the diagnosis of coronary artery disease (CAD). The aim of this work was to compare 201Thallium SPECT with different coronary angiographic cutoff values. Methods: Data pertaining to 145 patients were tabulated. All patients underwent stress ECG, 201Thallium SPECT and coronary angiography. To assess the cutoff impact, two criteria for coronary angiography diagnosis were used: a) >= 50 % and b) >= 75 % stenosis, and applied to data from patients and vessels. Results: On a patient basis, 201Thallium SPECT sensitivity, specificity and accuracy were 87 %, 57 % and 81 % with >= 50 % cutoff and 93 %, 51 % and 79 % with >= 75 % cutoff, respectively (NS). When performing individual vessel analysis, sensitivity, specificity and accuracy were 59 %, 78 % and 68 % for >= 50 % cutoff and 70 %, 75 % and 74 % for >= 75 % cutoff, respectively (p = 50 % stenosis cutoff criteria for CAD diagnosis and evaluation. Combined with coronary angiography, myocardial SPECT offers an excellent management strategy to patients