Kuzume O, Hamashige N, Yonezawa Y, Doi Y, Odawara H, Chikamori T, Ozawa T, Akagi N, Yoshida S, Maeda T
Kaku Igaku. 1989 Jun;26(6):753-62.
Six hundred seventy-one patients who had dipyridamole perfusion scintigraphy were classified into two groups; ie, 242 patients without perfusion defect (Group A) and 429 patients with perfusion defect (Group B). Clinical significance of negative scintigram was then assessed and correlated with coronary angiographic findings and prevalence of cardiac events. 1) Significant coronary artery disease (greater than 50% luminar narrowing) was present in 7 of 92 patients (8%) in Group A and in 235 of 285 patients (82%) in Group B. Multi-vessel coronary artery disease was found only in 2 patients (2%) in Group A and in 119 patients (42%) in Group B. 2) During a mean follow-up period of 29 months, 48 cardiac death (8%) and 19 nonfatal cardiac events (3%) occurred in 619 medically treated patients. These cardiac complications were observed in 7 of 242 patients (3%) in Group A and in 60 of 377 patients (16%) in Group B, including 4 (2%) and 44 (12%) cardiac deaths, respectively. In conclusion, it is rare to see severe organic coronary artery disease and future cardiac event in patients with negative dipyridamole perfusion scintigram. It may be, therefore, stated that it is unnecessary to perform coronary angiography in these patients, unless they have symptoms which cannot be controlled medically.
671例行双嘧达莫灌注闪烁扫描的患者被分为两组，即242例无灌注缺损患者（A组）和429例有灌注缺损患者（B组）。然后评估闪烁扫描阴性的临床意义，并将其与冠状动脉造影结果及心脏事件发生率进行关联分析。1）A组92例患者中有7例（8%）存在显著冠状动脉疾病（管腔狭窄大于50%），B组285例患者中有235例（82%）存在显著冠状动脉疾病。A组仅2例患者（2%）发现多支冠状动脉疾病，B组119例患者（42%）发现多支冠状动脉疾病。2）在平均29个月的随访期内，619例接受药物治疗的患者中发生48例心源性死亡（8%）和19例非致死性心脏事件（3%）。这些心脏并发症在A组242例患者中有7例（3%）出现，在B组377例患者中有60例（16%）出现，分别包括4例（2%）和44例（12%）心源性死亡。总之，双嘧达莫灌注闪烁扫描阴性的患者很少出现严重器质性冠状动脉疾病和未来心脏事件。因此，可以说除非这些患者有药物无法控制的症状，否则无需对其进行冠状动脉造影。
