Effectiveness of nuclear scan strategy in low-risk chest pain patients: Novel insights from the real world

Alberto Conti, Margherita Luzzi, Cristina Nanna, Chiara Gallini, Egidio Costanzo, Luca Vaggelli, Luigi Padeletti, Gian Franco Gensini

Research output: Contribution to journalArticlepeer-review

Abstract

AIM: The aim this study is to update the diagnostic implementation of a costly scan strategy in chest pain (CP) patients. Methods: Low-risk CP patients with a negative first-line work-up including clinical evaluation, serial ECGs, and serial troponins underwent stress myocardial perfusion imaging (MPI). Those with perfusion defects underwent angiography, whereas the remaining patients were discharged and followed up. The endpoint was coronary stenosis greater than or equal to 50% at angiography or cardiovascular death, myocardial infarction, unstable angina, and revascularization at follow-up. Results: Out of 1089 patients enrolled, 966 underwent exercise-MPI and 123 pharmacological-MPI (91 adenosine-MPI and 32 dipyridamole-MPI). Areas under the receiver-operating characteristic curve of exercise-MPI and pharmacological-MPI were comparable. The sensitivity and negative predictive value were significantly higher in patients subjected to exercise-MPI or pharmacological-MPI versus exercise-ECG or pharmacological-ECG (P

Original languageEnglish
Pages (from-to)1223-1230
Number of pages8
JournalNuclear Medicine Communications
Volume32
Issue number12
DOIs
Publication statusPublished - Dec 2011

Keywords

  • coronary artery disease
  • exercise stress testing
  • myocardial ischemia
  • myocardial perfusion imaging
  • prognosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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