Sensitivity, specificity, positive predictive value, and negative predictive value of the dipyridamole sestambi stress test comparing arterial to vein conduits

Study objectives: To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the dipyridamole stress test (DSST) in predicting ≥ 50% obstruction of an internal mammary artery or new native coronary artery disease (CAD) compared with saphenous vein graft obstruction a 50% in patients with prior coronary artery surgery and symptoms. Design: In 144 patients with prior coronary artery surgery who underwent a DSST within 8 ± 7 days of coronary angiography performed because of cardiac symptoms, we investigated the sensitivity, specificity, PPV, and NPV of the DSST in predicting ≥ 50% obstruction of an internal mammary artery or new native CAD (201 total arterial conduits) vs ≥ 50% obstruction of saphenous vein grafts (total saphenous grafts = 246). Setting: A university hospital. Patients: The 144 patients included 88 men and 56 women, mean age 68 ± 9 years (± SD). Results: The DSST had a sensitivity of 81%, a specificity of 87%, a PPV of 84%, and a NPV of 84% in predicting ≥ 50% obstruction of an internal mammary artery or new native CAD. The DSST had a sensitivity of 88%, a specificity of 82%, a PPV of 86%, and a NPV of 85% in predicting ≥ 50% obstruction of saphenous vein grafts. Conclusion: There was no significant difference in sensitivity, specificity, PPV, or NPV of the DSST in predicting ≥ 50% obstruction of an internal mammary artery or new native CAD vs predicting ≥ 50% obstruction of saphenous vein grafts in patients with prior coronary artery surgery and cardiac symptoms.