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(Chest. 2004;126:1040-1041.)
© 2004 American College of Chest Physicians

Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value of the Dipyridamole Sestamibi Stress Test Comparing Arterial to Vein Conduits*

Albert J. DeLuca, MD; Evelyn Cusack, MD; Wilbert S. Aronow, MD, FCCP and Craig E. Monsen, MD

* From the Department of Medicine, Cardiology Division, Westchester Medical Center/New York Medical College, Valhalla, NY.

Correspondence to: Wilbert S. Aronow, MD, Cardiology Division, New York Medical College, Macy Pavilion, Room 138, Valhalla, NY 10595; e-mail: WSAronow{at}aol.com

Study objectives: To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the dipyridamole stress test (DSST) in predicting ≥ 50% obstruction of an internal mammary artery or new native coronary artery disease (CAD) compared with saphenous vein graft obstruction ≥ 50% in patients with prior coronary artery surgery and symptoms.

Design: In 144 patients with prior coronary artery surgery who underwent a DSST within 8 ± 7 days of coronary angiography performed because of cardiac symptoms, we investigated the sensitivity, specificity, PPV, and NPV of the DSST in predicting ≥ 50% obstruction of an internal mammary artery or new native CAD (201 total arterial conduits) vs ≥ 50% obstruction of saphenous vein grafts (total saphenous grafts = 246).

Setting: A university hospital.

Patients: The 144 patients included 88 men and 56 women, mean age 68 ± 9 years (± SD).

Results: The DSST had a sensitivity of 81%, a specificity of 87%, a PPV of 84%, and a NPV of 84% in predicting ≥ 50% obstruction of an internal mammary artery or new native CAD. The DSST had a sensitivity of 88%, a specificity of 82%, a PPV of 86%, and a NPV of 85% in predicting ≥ 50% obstruction of saphenous vein grafts.

Conclusion: There was no significant difference in sensitivity, specificity, PPV, or NPV of the DSST in predicting ≥ 50% obstruction of an internal mammary artery or new native CAD vs predicting ≥ 50% obstruction of saphenous vein grafts in patients with prior coronary artery surgery and cardiac symptoms.

Key Words: coronary artery disease • coronary artery surgery • dipyridamole sestamibi stress test • internal mammary artery • saphenous vein grafts






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