[Myocardial scintigraphy and coronary arteriography in patients with known or suspected stable angina pectoris]
A H Johansen1, T S Poulsen, P F Høilund-Carlsen
1Odense Universitetshospital, nuklearmedicinsk afdeling og kardiologisk afdeling B.
Introduction:
Myocardial perfusion imaging (MPI) demonstrates regional hypoperfusion, whereas coronary angiography shows anatomical stenoses in epicardial arteries. Both modalities are potentially relevant in patients with stable angina pectoris.
Materials And Methods:
MPI was undertaken before angiography in 86 randomly selected patients with stable angina pectoris.
Results:
Of 78 adequately stressed patients, MPI was normal in 28 (36%) and showed reversible and irreversible perfusion abnormalities in 30 (38%) and 20 patients (26%), respectively. Coronary angiograms were normal in 28 (36%) and revealed at least one > or = 50% stenosis in 50 patients (64%) (16 with single vessel and 34 with multivessel disease). With angiography as reference, the sensitivity and specificity of MPI in the detection of coronary artery disease were 88% and 93%, respectively.
Discussion:
Patients with stable angina pectoris and a normal MPI have a very low risk of cardiac events and do not usually require invasive investigation and therapy. Reversible ischaemia and irreversible ischaemia with viable tissue call for coronary revascularisation.
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