Dipyridamole administration at the end of an insufficient exercise Tc-99m MIBI SPECT improves detection of multivessel coronary artery disease in patients with previous myocardial infarction

Am J Cardiol. 2000 Mar 1;85(5):532-5. doi: 10.1016/s0002-9149(99)00806-1.


To demonstrate that the administration of dipyridamole at the end of an insufficient maximal subjective exercise test can improve the diagnostic accuracy of single-photon emission computed tomography in patients with previous myocardial infarction, 209 consecutive patients were studied with technetium-99m methoxyisobutyl isonitrile single-photon emission computed tomography and coronary angiography. Patients were divided in 3 groups: group 1, 107 patients with sufficient exercise testing; group 2, 55 patients with insufficient exercise testing; group 3, 47 patients with insufficient exercise testing in whom intravenous dipyridamole (0.56 mg/kg over 4 minutes) was administered at the end of exercise. In groups 1 and 3 the sensitivity values for the diagnosis of multivessel disease were significantly higher (80% and 76%, respectively) than those in group 2 (59% [p = 0.009 and p = 0.02, respectively]). Specificity and predictive values were not different among the 3 groups. Thus, in patients with previous infarction in whom adequate levels of exercise could not be achieved, dipyridamole administration at the end of exercise significantly increased the sensitivity for diagnosing multivessel disease.

MeSH terms

  • Cardiac Catheterization
  • Case-Control Studies
  • Coronary Disease / complications
  • Coronary Disease / diagnostic imaging*
  • Coronary Disease / epidemiology
  • Dipyridamole* / administration & dosage
  • Exercise Test
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Predictive Value of Tests
  • Prospective Studies
  • Radiopharmaceuticals
  • Sensitivity and Specificity
  • Technetium Tc 99m Sestamibi*
  • Tomography, Emission-Computed, Single-Photon*
  • Vasodilator Agents* / administration & dosage


  • Radiopharmaceuticals
  • Vasodilator Agents
  • Dipyridamole
  • Technetium Tc 99m Sestamibi