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

Ziyang Huang; Sadayoshi Komori; Takao Sawanobori; Isao Kohno; Souichi Sano; Tsukasa lshihara; Ken Umetani; Hiroshi Ijiri; Kiyoshi Koizumi; Tsutomu Araki; Kihachiroh Kamiya; Yuusuke Tada; Kohji Tamura

doi:10.1253/jcj.62.274

Clinical Study

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

Ziyang Huang, Sadayoshi Komori, Takao Sawanobori, Isao Kohno, Souichi Sano, Tsukasa lshihara, Ken Umetani, Hiroshi Ijiri, Kiyoshi Koizumi, Tsutomu Araki, Kihachiroh Kamiya, Yuusuke Tada, Kohji Tamura

Author information

Ziyang Huang
Present address: Department of Medicine, Second Affiliated Hospital, Fujian Medical College, Zhongshan St, North, Quanzhou 362000
Sadayoshi Komori
Second Department of Medicine
Takao Sawanobori
Second Department of Medicine
Isao Kohno
Second Department of Medicine
Souichi Sano
Second Department of Medicine
Tsukasa lshihara
Second Department of Medicine
Ken Umetani
Second Department of Medicine
Hiroshi Ijiri
Second Department of Medicine
Kiyoshi Koizumi
Department of Radiology
Tsutomu Araki
Department of Radiology
Kihachiroh Kamiya
Second Department of Surgery, Yamanashi Medical University
Yuusuke Tada
Second Department of Surgery, Yamanashi Medical University
Kohji Tamura
Second Department of Medicine

Keywords: Dipyridamole ²⁰¹ Tl-SPECT, Arteriosclerosis obliterans, Cardiac event, Clinical risk factor

JOURNAL FREE ACCESS

1998 Volume 62 Issue 4 Pages 274-278

DOI https://doi.org/10.1253/jcj.62.274

Details

Abstract

The aim of the study was to determine whether or not dipyridamole thallium-201 single-photon emission computed tomography (²⁰¹Tl-SPECT) has significant additive value for predicting perioperative cardiac events in patients with arteriosclerosis obliterans (ASO) undergoing vascular surgery. Routine preoperative ²⁰¹Tl-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 ²⁰¹Tl-SPECT data to clinical risk-stratified patients with ASO allows better prediction of perioperative cardiac events. (Jpn Circ J 1998; 62: 274-278)

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