[Prognosis of Duke treadmill score versus scintilography in patients at risk for coronary artery disease. One year follow-up].
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.
Gasperin
Carlos Alberto
CA
Centro de Radiomunoensaio e Medicina Nuclear do Paraná, CERMEN, Curitiba, PR, Brazil. acgasperin@cendicor.com.br
Bueno
Caroline Pereira
CP
Yamada
Airton Seiji
AS
da Rocha
Gilberto Alves
GA
Heinze
Regina Célia Portugal Freixo
RC
Nunes
Débora Cristina Fontoura de Mello
DC
Trevisan
Isabelle Vianna
IV
Mostiack
Deisi Raquel
DR
Xavier
Lânia Romanzin
LR
Silva
Cláudia Maria Castelo Branco
CM
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
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi