Detection of coronary artery disease using 12-lead electrocardiogram and simultaneous dual myocardial imaging with iodine-123-beta-methyl iodophenyl-pentadecanoic acid (BMIPP) and thallium-201 in patients with unstable angina.

We investigated the usefulness of 12-lead electrocardiogram and simultaneous single-photon emission computed tomography (SPECT) with 123I-beta-methyl iodophenyl-pentadecanoic acid (BMIPP) and thallium-201 (201Tl) for detecting coronary artery disease (CAD) in 54 consecutive patients with unstable angina. Discordant BMIPP uptake was defined as less 123I-BMIPP uptake than 201Tl uptake in 123I-BMIPP/201Tl dual SPECT. In the detection of CAD, ischemic electrocardiographic change during anginal attack had high sensitivity and low specificity, while discordant BMIPP finding had low sensitivity and high specificity. In patients showing ST depression during anginal attack, discordant BMIPP uptake showed high sensitivity and high specificity for detecting CAD. In conclusion, both 12-lead electrocardiogram during anginal attack and discordant BMIPP uptake are useful in detecting CAD in patients with unstable angina.