LIMITED UTILITY OF DIPYRIDAMOLE-THALLIUM FOR PREDICTING ADVERSE CARDIAC EVENTS AFTER VASCULAR-SURGERY

The objective of this retrospective study was to determine the value o f dipyridamole-thallium (PTHAL) and Eagle criteria (Q wave on EGG, ven tricular ectopy, diabetes, congestive heart failure, age greater than or equal to 70, angina) in predicting cardiac events after vascular su rgery at a Veteran Affairs hospital. The main outcome measures were ad verse cardiac events. Of 211 vascular procedures, 148 were performed w ithout, and 63 performed with, preoperative PTHAL. Thirty-six patients had redistribution on PTHAL, but only two underwent preoperative coro nary revascularization. There were 10 cardiac events (4.8%), five in e ach group (p=NS). Cardiac events were increased with greater than or e qual to one Eagle criteria (6.7% vs 0% with no Eagle, p=0.04), but not with PTHAL redistribution. Conclusions: Prior to elective vascular su rgery: (1) PTHAL redistribution did not predict cardiac events. (2) Ca rdiac morbidity was increased with greater than or equal to one Eagle criteria. (3) Cardiac testing is not indicated in patients without Eag le criteria.