title: [Prognosis of Duke treadmill score versus scintilography in patients at risk for coronary artery disease. One year follow-up].
abstract: OBJECTIVE
  The purpose was to determine the sensitivity, the specificity and a year-long risk of subsequent cardiovascular events in patients with low, intermediate and high risk prognostic Duke treadmill score (DTS) in comparison with the presence (or not) of the myocardial perfusion defects on radionuclide images.
  
  
  METHODS
  A prospective study, with 173 consecutive patients with 02 or more risk factors to coronary artery disease (CAD), who underwent to exercise single photon - emission computed tomographic myocardial perfusion images using technetium-99m tetrophosmin (SPECT) and treadmill test (with DTS), from one neighbourhood of Curitiba city, between January 2003 and February 2004, were followed up for cardiac-cause mortality and major cardiac events. Follow-up was performed in 13+/- 1 months and in 162 patients was complete.
  
  
  RESULTS
  The DTS mean those patients with cardiac event (18) over a year was -0.27 (95% CI= -3.97 to +3.91) and those free cardiac event patients (144) was +4.92 (95% CI= +4.03 to +5.81), with p<0.00069. The DTS sensitivity was 72.22% and the SPECT sensitivity was 77.78%, with no significant difference p=0.21. The DTS specificity was 54.17% and the SPECT specificity was 88.19%, with p<0.0001. The cumulative proportion free-events (Kaplan-Meier) curves demonstrated that 94% those patients with low-risk DTS remained free-cardiac events. In contrast, all high-risk DTS had adverse cardiac events. Those patients with intermediate-risk DTS had 15% of cardiac event over a year.
  
  
  CONCLUSIONS
  The DTS was as sensitivity as SPECT in determine a year risk for CAD. Those patients with DTS <-0.27 had high-risk cardiac event.
authors.affiliation: Centro de Radiomunoensaio e Medicina Nuclear do Paraná, CERMEN, Curitiba, PR, Brazil. acgasperin@cendicor.com.br
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Gasperin
authors.forename: Caroline Pereira
authors.initials: CP
authors.lastname: Bueno
authors.forename: Airton Seiji
authors.initials: AS
authors.lastname: Yamada
authors.forename: Gilberto Alves
authors.initials: GA
authors.lastname: da Rocha
authors.forename: Regina Célia Portugal Freixo
authors.initials: RC
authors.lastname: Heinze
authors.forename: Débora Cristina Fontoura de Mello
authors.initials: DC
authors.lastname: Nunes
authors.forename: Isabelle Vianna
authors.initials: IV
authors.lastname: Trevisan
authors.forename: Deisi Raquel
authors.initials: DR
authors.lastname: Mostiack
authors.forename: Lânia Romanzin
authors.initials: LR
authors.lastname: Xavier
authors.forename: Cláudia Maria Castelo Branco
authors.initials: CM
authors.lastname: Silva
mesh_terms: D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D004812:Epidemiologic Methods; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi