PROGNOSTIC VALUE OF EXERCISE RADIONUCLIDE ANGIOGRAPHY IN CORONARY-ARTERY DISEASE

The predictive value for cardiac events in stable coronary artery dise ase was analysed sed with resting and exercise radionuclide angiograph y and conventional exercise stress testing under medical therapy. The population comprised 93 men and 12 women, followed up for 1 to 8 years (mean 51 months). The patients were divided into two groups. Group I without cardiac events; Group II including spontaneous complications a nd myocardial revascularisations. The analysis was performed at 2 year s and at the end of follow-up. At 2 years, 30 events (15 spontaneous c omplications, 15 revascularisations) were observed, and at the end of follow-up, there were 61 uncomplicated outcomes and 44 cardiac events (22 spontaneous complications, 22 revascularisations). Two independant prognostic factors distinguishing patients in Group I from those in G roup II were identified at 2 years and at the end of the study: exerci se EF and occurrence of exercise (on: chest pain on exercise) chest pa in. Four parameters were significantly different between the two group s at 2 years : exercise EE resting EE difference between exercise-rest ing EF (all p < 0.005) and duration of exercise testing (p = 0.04). Th e 3 radionuclide parameters remained different between the 2 groups as well as chest pain on exercise stress testing (p = 0.03) throughout t he study. The predictive value of these parameters depended on the typ e of cardiac event. The exercise EF was the best predictive factor of cardiac death. Pain and ST depression on exercise ECG were the best pr edictive factors for myocardial revascularisation. In 12 patients unde rgoing myocardial revascularisation, the dearest improvement was obser ved in exercise EF (p = 0.01). Therefore, exercise EF had proper predi ctive value, especially for cardiac death.