Selection of the optimal stress test for the diagnosis of coronary artery disease

102 consecutive patients with chest pain and no previous history of coronary artery disease. 10 patients with left bundle branch block were excluded for further analysis of exercise testing and scintigraphy results.

Four stress tests assessed in random order: exercise testing, dipyridamole echocardiography, dobutamine-atropine echocardiography, and MIBI-SPECT (technetium-99m methoxyisobutyl nitrile single photon emission computed tomography) during dobutamine infusion.

Coronary angiography (reference standard for confirming the presence or absence of coronary artery disease).

Diagnostic accuracy (sensitivity, specificity, positive and negative predictive values) for detecting coronary artery disease.surrogate