Sensibilidad y especificidad de la prueba de esfuerzo y el estudio de perfusión miocárdica con SESTAMIBI para detección de enfermedad arterial coronaria, en el Hospital San Juan de Dios

aim: coronary artery disease is the first cause of mortality around the world, and costa rica does not escape from this reality. the treadmill test, myocardial perfusion imaging with sestamibi, and coronary angiography are methods for detecting this disease. our country does not have its own data regarding these tests. the aim of this study is to determine the diagnostic performance of each one. methods: the present is an observational, analytic, cohort study. patients included were those with cardiovascular risk factors that underwent a treadmill test, myocardial perfusion imaging, and a coronary angiography at the hospital san juan de dios, from 2003 to 2007. sensitivity and specificity were calculated. adescriptive statistic analysis of the different risk factors was carried out. results: eighty three patients were included in the study; 75% men and 25% women. the most frequently found risk factors were dyslipidemia (84%), and hypertension (70%). the treadmill test had a sensitivity of 40%, and specificity of 57%. myocardial perfusion imaging with sestamibi had a sensitivity of 66% and specificity of 71%. the majority of the patients had lesions in 1 or 2 coronary arteries, with more than 90% obstruction, mostly in the anterior artery descending. conclusion: a high prevalence of conventional risk factors was present in this population. the treadmill test showed a low sensitivity and specificity, according with the literature. the myocardial perfusion imaging had a significant (p =0.05) better diagnostic performance than the treadmill test.