title: Prognostic implications of normal exercise tomographic thallium images in patients with angiographic evidence of significant coronary artery disease.
abstract: This study examines the prognostic implications of normal exercise tomographic thallium images in medically treated patients with angiographic evidence of coronary artery disease (CAD). There were 97 patients aged 60 +/- 10 years; 52 had 1-, 30 had 2-, and 15 had 3-vessel CAD (> or = 50% diameter stenosis). The exercise test was submaximal in 51 patients (53%); ST-segment depression during exercise occurred in 20 patients (21%), and angina during exercise occurred in 23 patients (24%). Most patients (71%) were receiving antianginal therapy. During a mean follow-up of 32 months, only 3 patients had cardiac events: 2 died of cardiac causes and 1 had nonfatal myocardial infarction (event rate 1.1%/year). None of those 3 patients had positive ST response during exercise. Thus, medically treated patients with CAD (including those with multivessel CAD) have a benign prognosis in the presence of normal exercise thallium images. These results have important implications in patient management and cost of health delivery.
authors.affiliation: Philadelphia Heart Institute, Presbyterian Medical Center, Pennsylvania 19104.
authors.forename: A
authors.initials: A
authors.lastname: Abdel Fattah
authors.forename: A M
authors.initials: AM
authors.lastname: Kamal
authors.forename: S
authors.initials: S
authors.lastname: Pancholy
authors.forename: M
authors.initials: M
authors.lastname: Ghods
authors.forename: J
authors.initials: J
authors.lastname: Russell
authors.forename: D
authors.initials: D
authors.lastname: Cassel
authors.forename: V
authors.initials: V
authors.lastname: Wasserleben
authors.forename: J
authors.initials: J
authors.lastname: Heo
authors.forename: A S
authors.initials: AS
authors.lastname: Iskandrian
mesh_terms: D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes