title: Predictive value of early maximal exercise test and thallium scintigraphy after successful percutaneous transluminal coronary angioplasty.
abstract: Restenosis of the dilated vessel after percutaneous transluminal coronary angioplasty can be detected by non-invasive procedures but their ability to predict later restenosis soon after a successful angioplasty as well as recurrence of angina has not been assessed. A maximal exercise test and myocardial thallium perfusion scintigraphy were, therefore, performed in 91 asymptomatic patients a median of 5 weeks after they had undergone a technically successful angioplasty. Primary success of the procedure was confirmed by the decrease in percentage diameter stenosis from 64(12)% to 30(13)% as measured from the coronary angiograms and in the trans-stenotic pressure gradient (normalised for mean aortic pressure) from 0.61(0.16) to 0.17(0.09). A clinical follow up examination (8.6(4.9) months later) was carried out in all patients and a late coronary angiogram obtained in 77. The thallium perfusion scintigram showing the presence or absence of a reversible defect was highly predictive for restenosis whereas the exercise test was not. The positive predictive value of an abnormal scintigram was 82% compared with 60% for the exercise test (ST segment depression/or angina or both at peak workload). Angina or a new myocardial infarction occurred in 60% of patients with abnormal and in 21% of patients with normal scintigrams.
authors.forename: W
authors.initials: W
authors.lastname: Wijns
authors.forename: P W
authors.initials: PW
authors.lastname: Serruys
authors.forename: M L
authors.initials: ML
authors.lastname: Simoons
authors.forename: M
authors.initials: M
authors.lastname: van den Brand
authors.forename: P J
authors.initials: PJ
authors.lastname: de Feijter
authors.forename: J H
authors.initials: JH
authors.lastname: Reiber
authors.forename: P G
authors.initials: PG
authors.lastname: Hugenholtz
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000628:therapy*; D000800:Angioplasty, Balloon; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes; D011877:Radionuclide Imaging; D012008:Recurrence; D013793:Thallium
chemical_list: D011868:Radioisotopes; D013793:Thallium