Does ambulatory monitoring contribute to exercise testing and myocardial perfusion scintigraphy in the prediction of the extent of coronary artery disease in stable angina?

Journal Article

The role of ambulatory myocardial ischemia detection, in addition to exercise testing and myocardial perfusion scintigraphy, in the prediction of the angiographic severity of coronary artery disease in patients with stable angina was examined. Ninety-seven patients underwent ambulatory electrocardiographic monitoring, exercise testing with scintigraphy, and coronary angiography. In addition to the number of diseased vessels involved, proximal arterial segment and coronary artery jeopardy scores were calculated to evaluate the extent of disease and amount of myocardium at risk. Thirty patients (31%) had 1.8 +/- 1.8 episodes/24 hours of ambulatory ischemia (94% of episodes were asymptomatic) and were similar to 67 without ambulatory ischemia in regard to clinical characteristics, left ventricular function and mean number of diseased vessels involved. Proximal arterial segment and coronary artery jeopardy scores were greater in: (1) 30 patients with versus 67 without ambulatory ischemia (3.3 +/- 1.8 vs 1.9 +/- 1.5 [p = 0.0002] and 6.6 +/- 3.6 vs 5.0 +/- 3.4 [p = 0.03], respectively); (2) 78 with versus 19 without a positive exercise test (2.6 +/- 1.8 vs 1.4 +/- 0.8 [p = 0.0001] and 6.1 +/- 3.5 vs 3.0 +/- 2.5 [p = 0.0003], respectively); and (3) 69 with versus 6 without a positive perfusion scan (2.4 +/- 1.8 vs 1.0 +/- 0 [p = 0.0008] and 5.5 +/- 3.6 vs 2.3 +/- 2.0 [p = 0.03], respectively). In multivariate analysis, ambulatory ischemia was the best predictor of the proximal segment score, whereas exercise testing and myocardial perfusion imaging were predictive of the coronary jeopardy score.

Full Text

Duke Authors

Cited Authors

  • Goodman, SG; Freeman, MR; Armstrong, PW; Langer, A

Published Date

  • April 1, 1994

Published In

Volume / Issue

  • 73 / 11

Start / End Page

  • 747 - 752

PubMed ID

  • 8160610

Electronic International Standard Serial Number (EISSN)

  • 1879-1913

International Standard Serial Number (ISSN)

  • 0002-9149

Digital Object Identifier (DOI)

  • 10.1016/0002-9149(94)90875-3

Language

  • eng