Limited usefulness of exercise testing and thallium scintigraphy in evaluation of ambulator patients several months after recovery from an acute coronary event: Implications for management of stable coronary heart disease
Key result
Exercise testing with or without thallium adds little predictive value for major events in stable CAD.
- P<0.05
- n=936
Why the study?
The usefulness of exercise testing with thallium perfusion imaging for predicting cardiac events in patients with stable coronary disease after recovery from an acute coronary event was uncertain.
Does exercise testing with thallium scintigraphy improve prediction of cardiac events in patients with stable coronary disease after recovery from an acute coronary event?
Comparison
Exercise treadmill testing with planar thallium-201 scintigraphy vs no testing
Design
Cohort study
Follow-up
Average 23 months (range 6 to 43)
Authors
Discussion
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Member takes
Implication
Minimal added prediction from exercise testing in stable CAD; leaves open need for superior risk tools post-ACS.
Study Design
Type
Cohort (n=936)
Structured PICO
Does exercise testing with thallium scintigraphy improve prediction of cardiac events in patients with stable coronary disease after recovery from an acute coronary event?
P
Population
936 patients with stable coronary disease evaluated 1 to 6 months after an acute coronary event and followed for an average of 23 months.
E
Exposure
Exercise treadmill testing with planar thallium-201 scintigraphy
O
Outcome
1) unstable angina requiring hospital admission, nonfatal myocardial infarction or cardiac death; 2) nonfatal infarction or cardiac death; or 3) cardiac death alonecomposite
Main Result
p-value: p=<0.05
Exercise testing and thallium scintigraphy have poor predictive performance for subsequent cardiac events in patients with stable coronary disease several months after an acute coronary event, limiting their clinical usefulness.
Cite This Study
Krone et al. (1994) conducted a cohort in Stable coronary disease (n=936). Exercise treadmill testing with planar thallium-201 scintigraphy vs. Clinical variables alone was evaluated on Unstable angina requiring hospital admission, nonfatal myocardial infarction, or cardiac death (p=<0.05). Exercise testing with or without thallium scintigraphy added little to the overall prediction of primary cardiac events (AUC increased from 0.649 to 0.663) in stable coronary disease.