[Effectiveness and safety of coronary vasodilation with adenosine triphosphate with thallium-201 for the diagnosis of coronary disease].
OBJECTIVE
To evaluate the accuracy and safety of pharmacologic stress testing with adenosine triphosphate (ATP) associated with thallium-201 scintigraphy for detection of coronary artery disease.


METHODS
We studied 44 patients, 35 male and 9 female with a mean age of 59 + 9 years. Previous myocardial infarction was present in 15 patients. Thirty-two patients underwent coronariography that revealed coronary artery disease in 28 patients.


METHODS
ATP (Stryadine) was infused at a rate of 140 micrograms/kg/min for 6 minutes and 2 mCi of thallium-201 was injected at the third minute. Stress and redistribution SPECT acquisitions were performed respectively 5-10 minutes and 4-6 hours after ATP infusion.


RESULTS
The incidence of side effects was 77% and chest pain was the most frequent (45%). Dyspnea occurred in 2 patients and only one patient presented transient first degree AV block. No serious or severe side effect occurred. In patients without myocardial infarction 14 of 16 patients with significant coronary artery disease had reversible perfusion defects demonstrated by ATP thallium-201 scintigraphy (sensitivity 88%) and all of 4 patients without significant coronary artery disease had normal myocardial perfusion (specificity 100%). The overall accuracy for detecting the presence of coronary artery disease was 90%. The test demonstrated an overall accuracy of 88% for detecting left anterior descending artery disease, 91% for circumflex artery disease and 80% for right coronary artery disease.


CONCLUSIONS
Pharmacologic stress with ATP associated with thallium-201 scintigraphy, is a safe and high accurate alternative to dipyridamole and adenosine for the diagnosis of coronary artery disease.
Ferreira
J
J
Departamento de Cardiologia Nuclear, Hospital de Santa Cruz, Carnaxide.
Gil
V M
VM
Ventosa
A
A
Calqueiro
J
J
Seabra-Gomes
R
R
D000255:Adenosine Triphosphate; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes; D000255:Adenosine Triphosphate
Eficácia e segurança da vasodilatação coronária com trifosfato de adenosina com tálio-201 para diagnóstico de doença coronária.