Exercise thallium-201 SPECT demonstrated superior diagnostic accuracy compared to the exercise ECG response for detecting coronary artery disease (79% vs. 49%, p < 0.0001).
Observational (n=321)
Does exercise thallium-201 SPECT improve diagnostic accuracy compared to exercise ECG in patients with normal baseline ECG results?
In patients with normal baseline ECGs, exercise thallium-201 SPECT provides superior diagnostic accuracy for detecting coronary artery disease compared to exercise ECG alone.
Absolute Event Rate: 79% vs 49%
p-value: p=< 0.0001
OBJECTIVES: This study compared the diagnostic accuracy of exercise thallium-201 single-photon emission computed tomography (SPECT) with the exercise electrocardiographic (ECG) response in patients with normal baseline ECG results. BACKGROUND: Previous studies comparing exercise thallium imaging with exercise electrocardiography have included patients with abnormal rest ECG results that may have biased the results in favor of thallium imaging. METHODS: Of 321 patients with a pretest likelihood of coronary artery disease of 70 +/- 29% (mean +/- SD) who underwent exercise stress testing and coronary angiography, 68 had no coronary artery disease; 94 had one-vessel disease; 79 had two-vessel disease; and 80 had three-vessel or left main coronary artery disease. RESULTS: The diagnostic accuracy of SPECT was higher than that of the ECG response (79% vs. 49%, p or = 2-mm ST segment depression, 44 (55%) had multivessel SPECT abnormalities, and 61 (76%) had either > or = 2-mm ST depression or multivessel SPECT abnormalities (p = 0.0005 vs. the ECG response; p = 0.01 vs. SPECT). CONCLUSIONS: In patients with an intermediate to high pretest probability of coronary artery disease and normal baseline ECG results, SPECT is superior to the ECG response in detecting coronary disease. Further, SPECT provides incremental power in identifying patients with extensive (left main or three-vessel) coronary disease.
Nallamothu et al. (Wed,) conducted a observational in Coronary artery disease (n=321). Exercise thallium-201 single-photon emission computed tomography (SPECT) vs. Exercise electrocardiographic (ECG) response was evaluated on Diagnostic accuracy for detecting coronary disease (p=< 0.0001). Exercise thallium-201 SPECT demonstrated superior diagnostic accuracy compared to the exercise ECG response for detecting coronary artery disease (79% vs. 49%, p < 0.0001).