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Title Silent ischemia after coronary angioplasty: Evaluation of restenosis and extent of ischemia in asymptomatic patients by tomographic thallium-201 exercise imaging and comparison with symptomatic patients
Creator/Author Hecht, H.S. ; Shaw, R.E. ; Chin, H.L. ; Ryan, C. ; Stertzer, S.H. ; Myler, R.K. (San Francisco Heart Institute, Daly City, CA (USA))
Publication Date1991 Mar 01
OSTI IdentifierOSTI ID: 6060089
Other Number(s)ISSN0735-1097; CODEN: JACCD
Resource TypeJournal Article
Resource RelationJournal of the American College of Cardiology ; Vol/Issue: 17:3
Subject550601 -- Medicine-- Unsealed Radionuclides in Diagnostics; HEART-- SCINTISCANNING;ISCHEMIA-- DIAGNOSIS; CORONARIES;EXERCISE;PATIENTS;SENSITIVITY ANALYSIS;SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY;SPECIFICITY;THALLIUM 201
Related SubjectARTERIES;BETA DECAY RADIOISOTOPES;BLOOD VESSELS;BODY;CARDIOVASCULAR DISEASES;CARDIOVASCULAR SYSTEM;COMPUTERIZED TOMOGRAPHY;COUNTING TECHNIQUES;DAYS LIVING RADIOISOTOPES;DIAGNOSTIC TECHNIQUES;DISEASES;ELECTRON CAPTURE RADIOISOTOPES;EMISSION COMPUTED TOMOGRAPHY;HEAVY NUCLEI;ISOMERIC TRANSITION ISOTOPES;ISOTOPES;NUCLEI;ODD-EVEN NUCLEI;ORGANS;RADIOISOTOPE SCANNING;RADIOISOTOPES;SECONDS LIVING RADIOISOTOPES;THALLIUM ISOTOPES;TOMOGRAPHY;VASCULAR DISEASES
Description/Abstract One hundred sixteen patients were evaluated to determine the ability of single photon emission computed tomographic (SPECT) thallium-201 exercise and redistribution imaging to detect silent ischemia secondary to restenosis in asymptomatic patients after single and multiple vessel percutaneous transluminal coronary angioplasty and the findings were compared with SPECT imaging detection of restenosis in symptomatic patients.^The value of exercise electrocardiography (ECG) and the amount of ischemic myocardium in symptomatic and asymptomatic patients were determined.^Forty-one patients were asymptomatic after angioplasty; 77% of these had chest pain before angioplasty.^Seventy-five patients had chest pain after angioplasty; 99% of these had chest pain before angioplasty.^Restenosis occurred in 61% of asymptomatic and 59% of symptomatic patients and in 46% of the vessels in both asymptomatic and symptomatic patients.^Sensitivity, specificity and accuracy for detection of restenosis by SPECT in individual patients were 96%, 75% and 88% versus 91%, 77% and 85%, respectively, in the asymptomatic versus symptomatic groups (p = NS).^Sensitivity, specificity and accuracy for restenosis detection in individual vessels were 90%, 89% and 89% versus 84%, 77% and 84%, respectively, in the asymptomatic and symptomatic groups (p = NS), with similar results for the three major arteries.^Sensitivity and accuracy of exercise ECG were significantly less than those of SPECT imaging for the patients with silent (40% and 44%) and symptomatic (59% and 64%) ischemia (p less than 0.001).^Restenosis of vessels in the patients with silent and symptomatic ischemia was associated with an equal amount and degree of severity of ischemic myocardium in the two groups.
Country of PublicationUnited States
LanguageEnglish
FormatPages: 670-677
System Entry Date2001 May 13

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