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[What coronary findings predispose to premature termination of a strong positive dipyridamole test?]
1Medizinischen Klinik-Kardiologie, St. Bonifatius Hospitals, Lingen (Ems), Deutschland.
Insights
Early termination of the dipyridamole-stress test due to angina or ST-segment depression indicates significant coronary artery disease (CAD). Patients with highly positive dipyridamole-tests often show severe coronary stenoses (>75%) in major arteries.
Area of Science:
- Cardiology
- Diagnostic Imaging
Context:
- Dipyridamole-stress testing is a key noninvasive method for diagnosing coronary artery disease (CAD).
- Early test termination due to symptoms like angina or ST-segment depression can complicate diagnosis.
Purpose:
- To determine expected coronary angiogram findings in patients with a highly positive dipyridamole-stress test.
- To correlate early test termination with the severity of coronary artery stenoses.
Summary:
- This study analyzed 218 patients undergoing dipyridamole-stress tests and coronary angiography.
- 70 tests were terminated early due to angina or ST-segment depression.
- Early termination for both angina and ST-segment depression was associated with a higher prevalence of severe coronary stenoses (>75%) compared to termination for angina alone.
Impact:
- Provides valuable insights for interpreting highly positive dipyridamole-tests in clinical practice.
- Highlights the strong correlation between early, symptom-driven test termination and significant coronary artery disease.
- Aids clinicians in anticipating the severity of CAD based on dipyridamole-test results.
Abstract:
Besides the exercise-ECG the dipyridamole-test is used in the noninvasive diagnosis of coronary artery disease (CAD). In many cases the test must be terminated due to angina or ST-segment depression before reaching the regular end point of the investigation. The test then is graded as highly positive. It was the aim of this study to answer the question what changes in the coronary angiogram one has to expect in patients with a highly positive dipyridamole-test. In 45 females and 173 males the dipyridamole-test was carried out giving 0.75 mg dipyridamole/kg bodyweight intravenously over a period of 10 min. In case of angina pectoris and/or ST-segment depression > 0.2 mV occurring within 12 min after beginning of injection the test was graded positive. The test was defined highly positive in the case of early termination during the injection period because of angina or ST-segment depression. All patients had undergone a coronary angiography. 70 out of 218 dipyridamole-tests had to be terminated before the regular end of the test. There was no correlation between the time of termination of the dipyridamole-test and the grade of CAD. The group of patients in which the test had to be terminated early because of angina and ST-segment depression more often had coronary stenoses > 75% in at least one major coronary artery (94.5%) compared with those patients in which only angina led to the termination of the test (69.6%).(ABSTRACT TRUNCATED AT 250 WORDS)