Usefulness of early radionuclide angiography for identifying low-risk patients for late restenosis after percutaneous transluminal coronary angioplasty.

This study evaluated the ability of exercise radionuclide angiography performed early after percutaneous transluminal coronary angioplasty (PTCA) to predict subsequent restenosis. Forty-eight patients with initially successful PTCA underwent early (less than or equal to 1 month) exercise radionuclide angiography and late (greater than 1 month, mean 8) coronary angiography. Findings on exercise radionuclide angiography were normal in 17 patients (35% of the entire group); none of these 17 patients had restenosis. Of the 31 patients with abnormal radionuclide angiographic findings, 13 had restenosis. When the exercise radionuclide angiogram was used to stratify patients according to risk of restenosis, the negative predictive value of a normal test was 100% (95% confidence limits = 81 to 100%) and the positive predictive value was 42%. By this method, 35% of the entire study population could be classified as low risk for restenosis after PTCA. Early exercise radionuclide angiography identifies subgroups of patients who are at low and high risk for early restenosis after PTCA.