Sensitivity and Specificity of Treadmill Test and Myocardial Perfusion Imaging with SESTAMIBI in the detection of Coronary Artery Disease at the Hospital San Juan de Dios

Aim: Coronary artery disease is the first cause of mortality in the world and Costa Rica does not escape this reality. The treadmill test, myocardial perfusion imaging with SESTAMIBI and coronary angiography are methods used to diagnose this disease. Our country does not have data regarding the information provided by these tests. The research’s aim is to determine the diagnostic performance of each of them. 

Methods: It is an observational, analytic cohort research. Patients included were those with cardiovascular risk factors that had undergone a treadmill test, a myocardial perfusion imaging test and a coronary angiography at the San Juan de Dios Hospital, from 2003 to 2007. The sensitivity and specificity of these tests was calculated. Also, a descriptive statistical analysis of the sample’s characteristics and of the different cardiovascular risk factors was conducted. 

Results: Eighty three patients were included in the study; 75% male. The main risk factors found were dyslipidemia (84%) and artery 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 patients had lesions in 1 or 2 coronary vessels, with more than 90% obstruction, mostly in the anterior descending artery. 

Conclusion: A high prevalence of conventional risk factors was present in the studied population. The treadmill test showed a low sensitivity and specificity, however, it coincides with the range described by literature. The myocardial perfusion imaging with SESTAMIBI showed a significantly higher diagnostic performance (p =0.05).