TY - JOUR
T1 - Influence of 99mTc-tetrofosmin SPECT myocardial perfusion imaging on the prediction of future adverse cardiac events
AU - Jain, Diwakar
AU - Lessig, Harry
AU - Patel, Riti
AU - Sandler, Leonard
AU - Weiland, Fred
AU - Edell, Steven L.
AU - Oates, M. Elizabeth
AU - O'Malley-Tysko, Erin
AU - Khutoryansky, Natalie
AU - Jacobson, Arnold F.
PY - 2009
Y1 - 2009
N2 - Background: The impact of myocardial perfusion imaging (MPI) on prediction of risk for future cardiac events was examined by comparing predictions based on clinical information alone and in combination with MPI findings. Methods and Results: A 3-cardiologist Cardiac Event Prediction Panel (CEPP) estimated three-year cardiac event (non-fatal MI; aborted sudden cardiac death; cardiac death) risk based on clinical data (C) for 371 subjects. CEPP repeated this estimation after receiving Summed Stress Scores (SSS) and Summed Rest Scores (SRS) from blinded reading of rest-stress 99mTc-tetrofosmin MPI SPECT studies (C + MPI). The C and C + MPI estimates were then compared with three-year and total event rates. MPI was normal (SSS ≤ 3) in 227 patients (61%), mildly abnormal (SSS 4-8) in 31 (8%), moderately abnormal (SSS 9-13) in 36 (10%), and severely abnormal (SSS > 13) in 77 (21%). Eighteen cardiac events occurred within 3 years and 33 occurred during a mean follow-up of 3.9 years. C + MPI estimates of low risk (<1-1.5%/year) identified significantly more patients who did not have events than C. C + MPI three-year event-rate predictions were more accurate than those made with C (P < .01). C + MPI categorization also provided better delineation of incremental risk on time-to-event analyses. Conclusions: 99mTc-tetrofosmin MPI single photon emission computed tomography (SPECT) findings significantly improve accuracy of cardiac event rate prediction compared to those based on clinical information alone.
AB - Background: The impact of myocardial perfusion imaging (MPI) on prediction of risk for future cardiac events was examined by comparing predictions based on clinical information alone and in combination with MPI findings. Methods and Results: A 3-cardiologist Cardiac Event Prediction Panel (CEPP) estimated three-year cardiac event (non-fatal MI; aborted sudden cardiac death; cardiac death) risk based on clinical data (C) for 371 subjects. CEPP repeated this estimation after receiving Summed Stress Scores (SSS) and Summed Rest Scores (SRS) from blinded reading of rest-stress 99mTc-tetrofosmin MPI SPECT studies (C + MPI). The C and C + MPI estimates were then compared with three-year and total event rates. MPI was normal (SSS ≤ 3) in 227 patients (61%), mildly abnormal (SSS 4-8) in 31 (8%), moderately abnormal (SSS 9-13) in 36 (10%), and severely abnormal (SSS > 13) in 77 (21%). Eighteen cardiac events occurred within 3 years and 33 occurred during a mean follow-up of 3.9 years. C + MPI estimates of low risk (<1-1.5%/year) identified significantly more patients who did not have events than C. C + MPI three-year event-rate predictions were more accurate than those made with C (P < .01). C + MPI categorization also provided better delineation of incremental risk on time-to-event analyses. Conclusions: 99mTc-tetrofosmin MPI single photon emission computed tomography (SPECT) findings significantly improve accuracy of cardiac event rate prediction compared to those based on clinical information alone.
KW - Myocardial perfusion imaging
KW - Prognosis
KW - Tc-tetrofosmin
KW - adversecardiac events
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U2 - 10.1007/s12350-009-9080-2
DO - 10.1007/s12350-009-9080-2
M3 - Article
C2 - 19396504
AN - SCOPUS:70249121432
SN - 1071-3581
VL - 16
SP - 540
EP - 548
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
IS - 4
ER -