[Nuclear cardiology in the preoperative evaluation of the patient at risk of coronary disease; meta-analysis of the contribution of thallium dipyridamole scintigraphy].

Coronary disease may be assessed by several techniques of nuclear cardiology: classical thallium myocardial scintigraphy, position scintigraphy, left ventricular angioscintigraphy. These techniques measure the response of coronary flow, myocardial metabolism, or left ventricular contractility during a physical or pharmacologic stress test. Many studies have reported the interest of dipyridamole thallium scintigraphy in the assessment of the surgical risk for a coronary event. Regarding the meta-analysis of up-to-day published studies, the surgical risk is 26% for an abnormal test against 3% for a normal study. Considering only the risk of infarction or cardiac death, corresponding probabilities are 18% and 2%, respectively. Dipyridamole stress test is a fairly safe and accurate method for discriminating between high and low risk patients in a population selected on clinical grounds.