PREDICTION OF SEVERE CORONARY-ARTERY DISEASE BY COMBINED REST AND EXERCISE RADIONUCLIDE ANGIOCARDIOGRAPHY AND TOMOGRAPHIC PERFUSION IMAGINGWITH TECHNETIUM 99M-LABELED SESTAMIBI - A COMPARISON WITH CLINICAL AND ELECTROCARDIOGRAPHIC DATA

Background. The purpose of this study was to compare the incremental v alue of clinical information, electrocardiographic data, myocardial pe rfusion imaging, and radionuclide angiography for predicting severe co ronary artery disease at a single testing interval. Clinical informati on, treadmill exercise studies, radionuclide angiography, and myocardi al perfusion imaging are important predictors of severe coronary arter y disease. However, the relative and absolute diagnostic importance of each of these methods has not been addressed at a single testing inte rval. Methods and Results. A same-day rest/treadmill exercise perfusio n and function study was performed in 167 patients within 90 days of c oronary angiography. A multivariable regression model was used to asse ss the independent informational content of these predictors, Clinical and electrocardiographic data were related strongly to the presence o f severe coronary artery disease (chi(2) = 12.2 and p < 0.001; chi(2) = 11.8 and p < 0.001, respectively), Combined perfusion and functional studies contributed 31% of the diagnostic information beyond that pro vided by clinical and electrocardiographic data alone (p < 0.05). Conc lusions. These data demonstrate that combined studies of myocardial pe rfusion and left ventricular function are able to improve prediction o f the extent of coronary artery disease, even when clinical and electr ocardiographic data are also available.