PROGNOSTIC VALUE OF THALLIUM-201 MYOCARDI AL SCINTIGRAPHY IN HYPERTENSION PATIENTS SUSPECTED OF CORONARY-DISEASE

Prognostic value of thallium 201 myocardial scintigraphy in hypertensi on patients suspected of coronary disease. - This study was undertaken to determine the prognostic value of exercise myocardial scintigraphy in hypertension patients suspected of coronary disease. One hundred a nd thirty six hypertension patients (mean age: 59) suspected of corona ry disease were monitored for 46 months after thallium 201 exercise my ocardial scintigraphy (tomographic mode). Prognostic factors analysed were clinical (typical nature of pain, exercise blood pressure), elect rocardiographic (presence of repolarisation abnormalities in resting E CG), ergometric (electrically positive test) and scintigraphic (existe nce or not of transitory hypofixation). Events sought were: death of c oronary origin, non-fatal myocardial infarction, aorto-coronary bypass and coronary angioplasty. One-way analysis showed that the existence of transitory hypofixation by scintigraphy, positive exercise electroc ardiogram and typical angina pain enabled the prediction of coronary e vents. Thus 14 of 36 patients (39 %) with transitory or combined hypof ixation had a coronary event as against 7 of the 100 patients without transitory hypofixation. Only the existence of transitory hypofixation retained a prognostic value for coronary events by multivariate analy sis (relative risk = 5.4, p = 0.001). It was also found that the progn osis was good when scintigraphy did not reveal transitory hypofixation while exercise testing was positive (2 coronary events/27 patients). It is concluded that, despite the possibility of ''false positives'', linked in particular to myocardial hypertrophy, myocardial scintigraph y offers better prediction of coronary events in hypertension patients that other clinical or electrocardiographic parameters.