Evidence map›Paper›PMID 27274174›Full record

ArticleActa Cardiologica Sinica2016

Chest Pain with Normal Thallium-201 Myocardial Perfusion Image - Is It Really Normal?

Pang-Yen Liu, Wen-Yu Lin, Li-Fan Lin, Chin-Sheng Lin, Wei-Shiang Lin, Shu-Meng Cheng, Shih-Ping Yang, Jun-Ting Liou

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Article in Acta Cardiologica Sinica, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Pang-Yen LiuDivision of Cardiology, Department of Internal Medicine;
Wen-Yu LinDivision of Cardiology, Department of Internal Medicine;
Li-Fan LinDepartment of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chin-Sheng LinDivision of Cardiology, Department of Internal Medicine;
Wei-Shiang LinDivision of Cardiology, Department of Internal Medicine;
Shu-Meng ChengDivision of Cardiology, Department of Internal Medicine;
Shih-Ping YangDivision of Cardiology, Department of Internal Medicine;
Jun-Ting LiouDivision of Cardiology, Department of Internal Medicine;

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThallium-201 myocardial perfusion image (MPI) is commonly used to detect coronary artery disease in patients with chest pain. Although a normal thallium-201 MPI result is generally considered to be a good prognosis and further coronary angiogram is not recommended, there are still a few patients who suffer from unexpected acute coronary events. The aim of this study was to investigate the clinical prognosis in patients with normal thallium-201 MPI.

methodsFrom January 2006 to August 2012, a total 22,003 patients undergoing thallium-201 MPI in one tertiary center were screened. Of these, 8092 patients had normal results and were investigated retrospectively. During follow-up, 54 patients underwent coronary angiogram because of refractory typical angina pectoris or unexpected acute coronary events. These 54 patients were divided into 2 groups: group I consisted of 26 (48.1%) patients with angiography-proven significant coronary artery stenosis, and group II consisted of 28 (51.9%) patients without significant stenosis.

resultsPatients in group I had a higher prevalence of prior coronary stenting and electrocardiographic features of ST depression compared with patients in group II. The multivariate analysis demonstrated that both prior coronary stenting and ST depression were risk predictors of unexpected acute coronary events in the patients with normal thallium-201 MPI [odds ratio (OR), 5.93; 95% confidence interval (CI): 1.03-34.06, p = 0.05 and OR, 7.10; 95% CI: 1.28-39.51, p = 0.03,respectively].

conclusionsAlthough there is a low incidence of unexpected acute coronary events in patients with chest pain and normal thallium-201 MPI, physicians should be aware of the potentials risk in certain patients in this specific population.

Indexed as

Acute coronary syndromeFalse negativeThallium-201

Identifiers

PMID27274174
PMCPMC4884761

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