[Coronary artery disease detected noninvasively by dipyridamole-loading 201T1 myocardial scintigraphy in elderly patients].

Abstract

To evaluate the usefulness in diagnosing coronary artery disease (CAD), dipyridamole-loading 201T1 myocardial scintigraphy was performed for 52 elderly patients (65-92 years, mean: 72 years), and the results were compared with data from the treadmill exercise tests. Thirty-five patients could not tolerate adequate exercise tests. Seven of them had reversible defects; six, fixed (irreversible) ones. Dipyridamole scintigraphy is therefore applicable in detecting CAD among patients with suspected CAD who are unable to perform adequate exercise tests. Four of 16 patients with positive exercise tests had no reversible defects; the exercise results in three were regarded as false positives. Seventeen patients experienced chest pain; 12 had ST depression during dipyridamole loading. There were no serious complications, but seven patients required aminophylline. We demonstrated previously that the sensitivity and specificity of dipyridamole scintigraphy in detecting CAD were 90% and 92%, respectively, in patients with chest pain undergoing coronary angiography. These results were superior to those of conventional exercise myocardial scintigraphy. Therefore, dipyridamole scintigraphy is regarded as a safe and useful method for detecting CAD, particularly in elderly patients who have ST and T wave abnormalities but cannot tolerate exercise test adequately.