COMPARISON OF PREDISCHARGE DIPYRIDAMOLE ECHOCARDIOGRAPHY WITH EXERCISE ELECTROCARDIOGRAPHY FOR THE PREDICTION OF MULTIVESSEL CORONARY-ARTERY DISEASE AFTER UNCOMPLICATED ACUTE MYOCARDIAL-INFARCTION

Background: The aim of this study is to compare the usefulness of dipyridamole echocardiography and exercise ECG in detecting the extent and severity of coronary artery disease in patients 7 to 10 days after an acute myocardial infarction. Methods: Dipyridamole echocardiography was performed in 46 patients, 7 to 10 days after an acute, uncomplicated myocardial infarction, treated with alteplase (recombinant tissue-type plasminogen activator). No major complications were observed during or after the test. Subsequently, all patients underwent ECG exercise testing. The results of both examinations were compared and correlated with the presence or absence of multivessel disease at coronary angiography performed within 24 hours of the two noninvasive tests. Results: The sensitivity and specificity of dipyridamole-induced new regional wall motion abnormalities in segments outside the infarct zone was 73% and 97%, respectively. Although submaximal exercise ECG showed the same specificity (97%), the sensitivity was significantly lower (13%). Conclusions: Dipyridamole echocardiography is a safe and more sensitive test than submaximal exercise ECG for defining the extent and severity of coronary artery disease early after an acute, uncomplicated myocardial infarction.