Dipyridamole Thallium-201 Single-Photon Emission Computed Tomography for Prediction of Perioperative Cardiac Events in Patients With Arteriosclerosis Obliterans Undergoing Vascular Surgery

概要

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The aim of the study was to determine whether or not dipyridamole thallium-201 single-photon emission computed tomography (^<201>T1-SPECT) has significant additive value for predicting perioperative cardiac events in patients with arteriosclerosis obliterans (ASO) undergoing vascular surgery. Routine preoperative ^<201>T1-SPECT was performed in 106 consecutive patients with ASO (age 68±8.9 years;91 men and 15 women). The frequency of reversible defects in a clinical high-risk group (n=44) was significantly higher than in a low-risk group (n=62;55% vs 24%, p<0.01). Perioperative cardiac events occurred in 9 patients, including 4 cardiac deaths, 1 non-fatal myocardial infarction, and 4 cases of unstable angina. Although clinical risk stratification was useful in predicting cardiac events (19% in the high-risk group vs 2% in the low-risk group, p<0.01), the positive predictive value was low. When considering a combination of 2 or more than 2 risk factors and a large reversible defect as a predictor, the positive predictive value and specificity increased from 19% to 47% and from 64% to 91%, respectively, whereas the sensitivity remained unchanged (89%). These results suggest that the addition of ^<201>T1-SPECT data to clinical risk-stratified patients with ASO allows better prediction of perioperative cardiac events.
社団法人日本循環器学会の論文
1998-03-20