Diffuse coronary atheromatosis and sensitivity/specificity to detect coronary stenosis by exercise thallium-201 scintigraphy

Ninety-four men aged 30-45 years underwent planar-exercise thallium-201 scintigraphy and coronary angiography after myocardial infarction. The coronary angiograms were scored with respect to localized stenosis and diffuse atheromatosis. The patients were grouped in quartiles on the basis of the atheromatosis score. Evaluation of left-anterior-descending (LAD) coronary artery lesions showed that the sensitivity for thallium-201 scintigraphy to detect coronary stenosis with ⩾75% reduction of luminal diameter decreased from 95% in the first to 59% in the fourth quartile. Concomitantly, the specificity increased from 60% to 100%. Thus, exercise thallium-201 scintigraphy in young men after myocardial infarction is more sensitive but less specific in finding significant stenosis in the LAD coronary artery in the presence of mild, compared to a severe, artheromatosis