Noninvasive identification of severe coronary artery disease using exercise tomographic thallium-201 imaging

Timothy F. Christian, Todd D. Miller, Kent R. Bailey, Raymond J. Gibbons

Research output: Contribution to journalArticlepeer-review

134 Scopus citations


The ability of exercise thallium-201 tomographic imaging to predict the presence of left main or 3-vessel coronary artery disease (CAD) was examined in 688 patients who underwent both exercise thallium-201 testing and coronary angiography. Significant differences existed for multiple variables between patients with (n = 196) and without (n = 492) severe left main or 3-vessel CAD. Logistic regression analysis identified 4 variables as independently predictive of left main or 3-vessel CAD. These variables were the magnitude of ST-segment depression with exercise, the number of visually abnormal short-axis thallium-201 segments, the presence or absence of diabetes mellitus, and the change in systolic blood pressure with exercise. Using these variables, patients were classified by nomograms into low-, intermediate-and high-probability groups. Patients at high probability (n = 205) had a 52% prevalence of 3-vessel or left main CAD, whereas those at tow probability (n = 170) had only a 12% prevalence. Only 53 patients (29%) with 3-vessel or left main CAD had perfusion abnormalities in all 3 coronary territories. Clinical and exercise parameters provide important independent information in the identification of toft main or 3-vessel CAD by exercise thallium-201 tomographic imaging, because thallium scintigraphy atone is suggestive of extensive CAD in few patients.

Original languageEnglish (US)
Pages (from-to)14-20
Number of pages7
JournalThe American journal of cardiology
Issue number1
StatePublished - Jul 1 1992

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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