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  • Title: Dipyridamole thallium-201 single-photon emission computed tomography for prediction of perioperative cardiac events in patients with arteriosclerosis obliterans undergoing vascular surgery.
    Author: Huang Z, Komori S, Sawanobori T, Kohno I, Sano S, Ishihara T, Umetani K, Ijiri H, Koizumi K, Araki T, Kamiya K, Tada Y, Tamura K.
    Journal: Jpn Circ J; 1998 Apr; 62(4):274-8. PubMed ID: 9583461.
    Abstract:
    The aim of the study was to determine whether or not dipyridamole thallium-201 single-photon emission computed tomography (201Tl-SPECT) has significant additive value for predicting perioperative cardiac events in patients with arteriosclerosis obliterans (ASO) undergoing vascular surgery. Routine preoperative 201Tl-SPECT was performed in 106 consecutive patients with ASO (age 68+/-8.9 years; 91 men and 15 women). The frequency of reversible defects in a clinical high-risk group (n=44) was significantly higher than in a low-risk group (n=62; 55% vs 24%, p<0.01). Perioperative cardiac events occurred in 9 patients, including 4 cardiac deaths, 1 non-fatal myocardial infarction, and 4 cases of unstable angina. Although clinical risk stratification was useful in predicting cardiac events (19% in the high-risk group vs 2% in the low-risk group, p<0.01), the positive predictive value was low. When considering a combination of 2 or more than 2 risk factors and a large reversible defect as a predictor, the positive predictive value and specificity increased from 19% to 47% and from 64% to 91%, respectively, whereas the sensitivity remained unchanged (89%). These results suggest that the addition of 201Tl-SPECT data to clinical risk-stratified patients with ASO allows better prediction of perioperative cardiac events.
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