IMPACT OF ANTIANGINAL MEDICATIONS, PEAK HEART-RATE AND STRESS LEVEL ON THE PROGNOSTIC VALUE OF A NORMAL EXERCISE MYOCARDIAL PERFUSION IMAGING STUDY

We sought to determine whether antianginal medications or the level of achieved stress affect the prognostic value of a normal exercise Tl-2 01 study. We studied 261 patients with a normal exercise Tl-201 study for 23 +/- 6 mo. Antianginal medications were taken at the time of str ess testing in 128 patients. Peak heart rate ranged from 82 to 217 bpm ; percent maximal predicted heart rate ranged from 42% to 136%. Chi-sq uare analysis was used to determine the relationship of cardiac events to antianginal medications and stress indices. Primary cardiac events were defined as cardiac death or nonfatal myocardial infarction. Prim ary cardiac events occurred in six patients yielding an annual inciden ce of 1.2% per year. There was no significant relationship between car diac event rate and antianginal medication use or any stress index, in cluding Bruce stage, peak heart rate or blood pressure or percent maxi mal predicted heart rate achieved. The risk of cardiac death or nonfat al myocardial infarction in patients with a normal exercise Tl-201 is low and is not affected by concurrent antianginal treatment or degree of stress achieved.