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Cardiac Risk in Vascular SurgeryThe Oral Dipyridamole-Thallium Stress Test
Michel S. Makaroun, MD;
Nursine Shuman-Jackson, MSN;
Anita Rippey, MSN;
David Schreiner, MD;
Stephen Arvan, MD
Arch Surg. 1990;125(12):1610-1613.
Abstract
• The value of the oral dipyridamole-thallium stress test in identifying patients at high risk of myocardial infarction after vascular procedures has not been documented. We studied prospectively 46 patients who underwent an oral dipyridamole-thallium stress test before undergoing vascular operations. Twenty patients (43%) had a positive test result, defined by a thallium defect with reperfusion, while 26 patients had a negative test result. Myocardial infarctions were documented postoperatively in 5(25%) of 20 of the group with positive results and 1 (4%) of 26 of the group with negative results. Three of the six myocardial infarctions were clinical; all three were in the group with positive results. No correlation was identified between dipyridamole-thallium stress test results and clinical cardiac history. A positive dipyridamole-thallium stress test result is a more sensitive predictor of postoperative myocardial infarction than ejection fraction or history of coronary artery disease. The oral dipyridamole-thallium stress test is as useful as the intravenous test in this setting.
(Arch Surg. 1990;125:1610-1613)
Author Affiliations
From the Departments of Surgery (Dr Makaroun) and Nuclear Medicine (Dr Schreiner) and Division of Cardiology (Dr Arvan), Veterans Affairs Medical Center; and the University of Pittsburgh School of Medicine (Drs Makaroun, Schreiner, and Arvan and Mss Shuman-Jackson and Rippey). Deceased.
Footnotes
Accepted for publication August 5, 1990.
Read before the 14th Annual Surgical Symposium of the Association of Veterans Affairs Surgeons, Charleston, SC, May 9, 1990.
Reprint requests to Veterans Affairs Medical Center (112), University Dr C, Pittsburgh, PA 15240 (Dr Makaroun).
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