Noninvasive Testing of Asymptomatic Patients for the Detection of Silent Ischemia After an Infarction: A Decision Analysis

Abstract

AbstractThis decision analysis estimates the overall gain in life expectancy and the relative efficacy of predischarge submaximal exercise electrocardiography, ambulatory cardiac monitoring, and thallium-201 scintigraphy for the identification of silent ischemia in asymptomatic postinfarct patients. A small, virtually equal increase in life expectancy can be obtained from any of the noninvasive tests (as compared to no testing). Large differences in life expectancy may result only when the prevalence of residual coronary artery disease and the probability of left-main and three-vessel lesions are high.