Sensitivity, specificity, positive predictive value, and negative predictive value of the dipyridamole sestamibi stress test comparing arterial to vein conduits.
OBJECTIVE
To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the dipyridamole stress test (DSST) in predicting > or = 50% obstruction of an internal mammary artery or new native coronary artery disease (CAD) compared with saphenous vein graft obstruction > or = 50% in patients with prior coronary artery surgery and symptoms.


METHODS
In 144 patients with prior coronary artery surgery who underwent a DSST within 8 +/- 7 days of coronary angiography performed because of cardiac symptoms, we investigated the sensitivity, specificity, PPV, and NPV of the DSST in predicting > or = 50% obstruction of an internal mammary artery or new native CAD (201 total arterial conduits) vs > or = 50% obstruction of saphenous vein grafts (total saphenous grafts = 246).


METHODS
A university hospital.


METHODS
The 144 patients included 88 men and 56 women, mean age 68 +/- 9 years (+/- SD).


RESULTS
The DSST had a sensitivity of 81%, a specificity of 87%, a PPV of 84%, and a NPV of 84% in predicting > or = 50% obstruction of an internal mammary artery or new native CAD. The DSST had a sensitivity of 88%, a specificity of 82%, a PPV of 86%, and a NPV of 85% in predicting > or = 50% obstruction of saphenous vein grafts.


CONCLUSIONS
There was no significant difference in sensitivity, specificity, PPV, or NPV of the DSST in predicting > or = 50% obstruction of an internal mammary artery or new native CAD vs predicting > or = 50% obstruction of saphenous vein grafts in patients with prior coronary artery surgery and cardiac symptoms.
Deluca
Albert J
AJ
Cardiology Division, New York Medical College, Macy Pavilion, Room 138, Valhalla, NY 10595, USA.
Cusack
Evelyn
E
Aronow
Wilbert S
WS
Monsen
Craig E
CE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000175:diagnosis*; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012501:Saphenous Vein / Q000637:transplantation*; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D014665:Vasodilator Agents
D014665:Vasodilator Agents; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi