title: Prognostic significance of normal dobutamine-atropine stress sestamibi scintigraphy in women with chest pain.
abstract: To evaluate the prognostic value of normal dobutamine-atropine technetium-99m sestamibi single-photon emission computed tomography (SPECT) perfusion imaging in women with chest pain and inability to perform an adequate exercise test, 80 women with a normal scintigram were followed up for 23 +/- 13 months. Mean age of the patients was 61 +/- 12 years. Nine patients (11%) had a low probability (< 10%) of coronary artery disease, 43 (54%) had an intermediate probability (10% to 80%) of disease, and 28 (35%) had a high probability (>80%) of disease (including 19 patients with known coronary artery disease). During follow-up, no major cardiac events (cardiac death or nonfatal myocardial infarction) occurred. One patient with known coronary disease underwent coronary bypass surgery after 3 months, and 1 patient with a 91% pretest likelihood of coronary disease underwent coronary angioplasty after 7 months. Thus, the overall incidence of (soft) cardiac events during the follow-up period was 2 of 80 patients, or 1.3%/year. It is concluded that normal dobutamine-atropine technetium-99m sestamibi SPECT perfusion imaging in women with chest pain implies an excellent prognosis, even in women with high pretest likelihood of coronary disease.
authors.affiliation: Thoraxcentre and the Department of Nuclear Medicine, University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, The Netherlands.
authors.forename: M L
authors.initials: ML
authors.lastname: Geleijnse
authors.forename: A
authors.initials: A
authors.lastname: Elhendy
authors.forename: R T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: J H
authors.initials: JH
authors.lastname: Cornel
authors.forename: A E
authors.initials: AE
authors.lastname: Reijs
authors.forename: P M
authors.initials: PM
authors.lastname: Fioretti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001285:Atropine; D002637:Chest Pain / Q000000981:diagnostic imaging*; D003327:Coronary Disease / Q000000981:diagnostic imaging; D004280:Dobutamine; D005080:Exercise Test; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D004280:Dobutamine; D001285:Atropine; D017256:Technetium Tc 99m Sestamibi