Use of multivariate analysis to improve the accuracy of radionuclide angiography with stress in detecting coronary artery disease in men.
A multivariate analysis (MVA) system was derived retrospectively from a population of 76 males with coronary artery disease and 18 control subjects. Posterior probabilities were then derived from such a system prospectively in a new male population of 11 subjects with normal coronary arteries and hemodynamics and 63 patients with coronary artery disease. The sensitivity was 84% compared to that for change in ejection fraction (delta EF) greater than or equal to 5 criterion of 71% (p less than 0.01), the specificity was 91% compared to 73% for the delta EF greater than or equal to 5 criterion (p greater than 0.05), and the correct classification rate was 85% compared to 72% for the delta EF greater than or equal to 5 criterion (p less than 0.01). The significant variables were: change in EF with exercise, percent maximal heart rate, change in end-diastolic volume (delta EDV) with exercise, change in R wave, and exercise duration. Application of the multivariate approach to radionuclide imaging with stress, including both exercise and nuclear parameters, significantly improved the diagnostic accuracy of the test and allowed for a probability statement concerning the likelihood of disease.
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005080:Exercise Test; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013670:Sodium Pertechnetate Tc 99m; D013667:Technetium
D013667:Technetium; D013670:Sodium Pertechnetate Tc 99m