Screening of asymptomatic siblings of patients with premature coronary artery disease

The data presented suggest that exercise tomographic thallium imaging may be useful for detecting occult presymptomatic coronary disease in a high-risk population. Tomographic imaging appears to be more accurate than standard planar imaging for this purpose. Exercise electrocardiography, although less costly and more generally available, may have insufficient sensitivity for screening this type of population. The results of tomographic imaging, but not planar imaging, correspond with the anticipated distribution of coronary disease by age and sex and risk factor make-up. A study using coronary arteriography to validate the findings in siblings with positive tomographic studies is currently in progress.