Detecting occult coronary disease in a high-risk asymptomatic population

Exercise stress testing alone or with perfusion imaging is the standard screening method to determine the presence of obstructive coronary artery disease (CAD) in people with chest pain. In asymptomatic individuals with a family history of premature CAD, it is unclear whether abnormalities on these...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2003-02, Vol.107 (5), p.702-707
Main Authors: BLUMENTHAL, Roger S, BECKER, Diane M, YANEK, Lisa R, AVERSANO, Thomas R, MOY, Taryn F, KRAL, Brian G, BECKER, Lewis C
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cardiology. Vascular system
Coronary Angiography
Coronary Disease - diagnosis
Coronary Disease - diagnostic imaging
Coronary Disease - genetics
Coronary heart disease
Exercise Test
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Myocardial Ischemia - diagnosis
Predictive Value of Tests
Radionuclide Imaging
Risk Factors
Sex Factors
Siblings
Thallium Radioisotopes
Vascular Patency
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Summary:Exercise stress testing alone or with perfusion imaging is the standard screening method to determine the presence of obstructive coronary artery disease (CAD) in people with chest pain. In asymptomatic individuals with a family history of premature CAD, it is unclear whether abnormalities on these functional exercise tests represent significant coronary disease. An abnormal exercise test, thallium scan, or both occurred in 153 (21%) of 734 asymptomatic siblings of persons with documented CAD, of whom 105 underwent coronary angiography with quantitative analysis of stenosis severity. Overall, 95% had coronary atherosclerosis, but only 39% had 1 or more stenoses with >or=50% narrowing. Of 30 siblings in whom the exercise test and perfusion scan were both abnormal, 70% had >or=50% stenoses. The mean stenosis in arteries that fed perfusion defects was only 43+/-31%, and 68% of such stenoses were
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.0000048127.93169.88