Direct comparison of adenosine triphosphate infusion and exercise stress myocardial perfusion tomography in diagnosis of coronary artery disease

Objective To compare the clinical effects of adenosine triphosphate (ATP) and exercise stress using 99 Tc m-methoxyisobutylisonitrile (MIBI) SPECT imaging for detecting coronary artery disease (CAD) in identical CAD patient group. Methods Sixty-one patients suspected with CAD underwent 99 Tc m-MIBI myocardial perfusion tomographic imaging (MPI) at rest,and symptom-limited multistage exercise,or intravenous ATP (0.16 mg·kg -1 ·min -1 for 5 min) separately one day after the rest imaging. Forty-six of them also underwent coronary angiography. Results The sensitivity,specificity and accuracy of ATP-MPI and ST-MPI in detection of CAD were 90.9%,91.7%,91.3% and 86.4%, 91.7%,89.1%,respectively;and those in detection of ≥50% narrowing coronary artery were 84.6%,86.9%,86.2% and 84.6%,84.8%,84.8%,respectively. Side effects during ATP stress test occurred more frequently than that during exercise test (88.5% vs 54.1%,χ 2=17.669,P0.01),but all the adverse effects were mild and transient. Allopathy or interruption of ATP stress did not happen. Conclusion ATP-MPI is an accurate,safe modality and is comparable to ST-MPI for detecting CAD.