Valore prognostico incrementale degli indici scintigrafici di ipoperfusione miocardica in pazienti con prova da sforzo massimale. [The incremental prognostic value of the scintigraphic indices of myocardial hypoperfusion in patients with a maximal stress test].

The additional prognostic value of thallium imaging in patients who are capable of performing a maximal, symptom-limited electrocardiographic stress test is still uncertain. Thus, we evaluated the incremental prognostic value of exercise thallium-201 indexes of myocardial hypoperfusion in 296 patients with suspected or known coronary artery disease who performed a maximal ECG stress test. At 2 year follow-up 20 hard events (16 cardiac deaths and 4 non fatal myocardial infarctions) and 44 soft events (myocardial revascularization procedures) occurred. Considering total events, thallium imaging provided significant additional prognostic information to clinical and exercise stress test data in all patients (p < 0.001) and in patients with previous myocardial infarction (p < 0.001); in patients without previous infarction, whichever the end-point considered, thallium imaging did not add incremental prognostic value. When only hard events were considered, thallium variables added further information only in patients with previous myocardial infarction (p < 0.05). The results of this study demonstrate that scintigraphic indexes of myocardial hypoperfusion obtained by qualitative planar thallium imaging give incremental prognostic information in patients with previous myocardial infarction but not in the subset of patients without previous infarction.