An abnormal dipyridamole thallium/sestamibi fails to predict long-term cardiac events in vascular surgery patients.
Recent data demonstrate that dipyridamole-thallium (DTHAL) and sestamibi (DMIBI) are not predictive of adverse perioperative cardiac events in moderate-risk patients (one or more Eagle risk factors) undergoing major elective vascular surgery. Less data are available regarding the ability of DTHAL/DMIBI to predict adverse cardiac events on long term follow-up. We sought to determine whether an abnormal DTHAL/DMIBI is predictive of adverse cardiac events on long-term follow-up in moderate-risk patients undergoing major elective vascular surgery. Patients were enrolled prospectively between June 1997 and June 1999 at West Los Angeles VA and Harbor-UCLA Medical Centers. Adverse cardiac events were defined as congestive heart failure (CHF), myocardial infarction (MI), unstable angina (USA), and ventricular arrhythmias. Follow-up was obtained via clinic visits, telephone calls, and chart review. We studied 75 patients (76% male, 24% female) with a mean age of 65 years. Operative procedures were primarily femorodistal (83%) and aortic (16%). DTHAL/DMIBI results were normal in 35 patients (47%), demonstrated reversible ischemia in 26 (35%), and showed a fixed defect alone in 14 (18%). From the follow-up results of this study we conclude that there is no association between a reversible ischemia or an abnormal (fixed or reversible) DTHAL/DMIBI and adverse cardiac events or mortality on long-term follow-up in moderate-risk patients who have undergone major vascular surgery.
Department of Surgery, Division of Vascular Surgery, Harbor-UCLA Medical Center, 1000 W. Carson Street, Torrance, CA 90509, USA.
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de Virgilio
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Wall
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Ephraim
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Toosie
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Donayre
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White
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Elbassir
D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D004176:Dipyridamole; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000401:mortality; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011877:Radionuclide Imaging; D018570:Risk Assessment; D015996:Survival Rate; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi