April 24, 1987JAMA
Dipyridamole-thallium scanning in patients undergoing vascular surgery. Optimizing preoperative evaluation of cardiac risk
Key result
Preoperative dipyridamole-thallium scanning identified patients at risk for postoperative ischemic events, which occurred in 44.4% with reversible defects versus 0% without.
Why the study?
Does preoperative dipyridamole-thallium scanning and clinical risk stratification predict postoperative ischemic events in patients undergoing vascular surgery?
Population
111 patients undergoing vascular surgery (evaluated in two sets of 61 and 50 patients)
Comparison
Preoperative dipyridamole-thallium scanning and… vs Patients without reversible defects on imaging…
Design
Cohort
Follow-up
postoperative period
Authors
Discussion
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Overview
May refine preoperative risk assessment in vascular surgery; leaves open value of routine scanning in prospective trials.
Study Design
Type
Cohort (n=111)
Structured PICO
Does preoperative dipyridamole-thallium scanning and clinical risk stratification predict postoperative ischemic events in patients undergoing vascular surgery?
P
Population
111 patients undergoing vascular surgery prospectively evaluated to assess the role of dipyridamole-thallium imaging and clinical markers in predicting postoperative ischemic events.
E
Exposure
Preoperative dipyridamole-thallium scanning and clinical risk stratification (presence of congestive heart failure, angina, prior myocardial infarction, or diabetes)
C
Comparator
Patients without reversible defects on imaging or without clinical risk markers
O
Outcome
Postoperative ischemic eventshard clinical
Main Result
Absolute Event Rate: 44.4% vs 0%
Clinical markers can identify a low-risk subset of vascular surgery patients who do not require further testing, while dipyridamole-thallium scanning provides further risk stratification in clinically high-risk patients.
Cite This Study
Kim A. Eagle (1987) conducted a cohort in Patients undergoing vascular surgery (n=111). Preoperative dipyridamole-thallium scanning vs. No thallium redistribution (normal scan) was evaluated on Postoperative ischemic events (95% CI 0.256-0.624). Preoperative dipyridamole-thallium scanning identified patients at risk for postoperative ischemic events, which occurred in 44.4% with reversible defects versus 0% without.