TY - JOUR T1 - Predictive value of early maximal exercise test and thallium scintigraphy after successful percutaneous transluminal coronary angioplasty. JF - British Heart Journal JO - Heart SP - 194 LP - 200 DO - 10.1136/hrt.53.2.194 VL - 53 IS - 2 AU - W Wijns AU - P W Serruys AU - M L Simoons AU - M van den Brand AU - P J de Feijter AU - J H Reiber AU - P G Hugenholtz Y1 - 1985/02/01 UR - http://heart.bmj.com/content/53/2/194.abstract N2 - Restenosis of the dilated vessel after percutaneous transluminal coronary angioplasty can be detected by non-invasive procedures but their ability to predict later restenosis soon after a successful angioplasty as well as recurrence of angina has not been assessed. A maximal exercise test and myocardial thallium perfusion scintigraphy were, therefore, performed in 91 asymptomatic patients a median of 5 weeks after they had undergone a technically successful angioplasty. Primary success of the procedure was confirmed by the decrease in percentage diameter stenosis from 64(12)% to 30(13)% as measured from the coronary angiograms and in the trans-stenotic pressure gradient (normalised for mean aortic pressure) from 0.61(0.16) to 0.17(0.09). A clinical follow up examination (8.6(4.9) months later) was carried out in all patients and a late coronary angiogram obtained in 77. The thallium perfusion scintigram showing the presence or absence of a reversible defect was highly predictive for restenosis whereas the exercise test was not. The positive predictive value of an abnormal scintigram was 82% compared with 60% for the exercise test (ST segment depression/or angina or both at peak workload). Angina or a new myocardial infarction occurred in 60% of patients with abnormal and in 21% of patients with normal scintigrams. ER -