[Experience with the dipyridamole test in the diagnosis of coronary insufficiency]

In 1980-86 263 dipyridamole tests were made before or after ergometry on account of the diagnosis of coronary insufficiency and possible indication for coronarography. The sensitivity and specificity was evaluated in a group of 101 subjects where both examinations had been made. As a reference method the authors used ergometry with more strict criteria of positivity of the two tests (deviations of segment ST 0.2 mV, incl. stenocardia) which are in good agreement with coronarography. The sensitivity was 58.2 and the specificity 96% (in men 61.4 and 100%). On combination of 98 dipyridamole tests with immediately following ergometry of 39 negative ergometries 23 (58.6%) changed to positive. Of 38 coronarographies the dipyridamole test was positive in 73% and in some patients with affections of the three main branches it was negative. There was also one serious complication: a new myocardial infarction. Because of lower sensitivity the dipyridamole test does not replace ergometry, except when the latter cannot be performed. The combination of the two tests sensitizes ergometry. On account of the high specificity ergometry can be omitted when the test is positive, in particular in men. For diagnostic purposes the stricter variant of criteria for evaluation of the test is more reliable and almost specific.