Safety and clinical utility of combined intravenous dipyridamole/symptom-limited exercise stress test with thallium-201 imaging in patients with known or suspected coronary artery disease.

Dipyridamole-induced coronary hyperemia 201 Tl myocardial perfusion scintigraphy can detect ischemic regions in individuals unable to perform adequate exercise, but it has several limitations. Symptom-limited exercise supplementation to intravenous dipyridamole can potentially overcome them, but the safety and diagnostic accuracy for this combination has not been established. Between 1987 and 1991, 441 consecutive patients were assessed for combined symptom-limited exercise test preceded by i.v. dipyridamole. Clinical records could not be obtained for 37 patients, and 40 patients were not exercised because they were unable; therefore 384 patients (mean age 58±9.8 yr, 278 men) underwent symptom-limited exercise preceded by 0.56 mg/kg of dipyridamole and followed by planar 201 Tl perfusion scintigraphy