Independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in coronary artery disease

Iskandrian, Abdulmassih S.; Chae, Shung Chull; Heo, Jaekyeong; C, Stanberry; Wasserleben, Valerie; Cave, Virginia

doi:10.1016/0735-1097(93)90174-y

Cited by 338 publications

(126 citation statements)

References 31 publications

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“…After these publications, some authors studied the value of this procedure with regard to insulin-dependent diabetic patients being evaluated for PKT. The findings are in overall agreement with those noted in the vascular surgery series [5,16,18].…”

Section: Introductionsupporting

confidence: 82%

Noninvasive assessment of cardiac risk in type I diabetic patients being evaluated for combined pancreas-kidney transplantation using dipyridamole-MIBI perfusion

Fuster¹,

Magriñá²,

Ricart³

et al. 2000

Transplant Int

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AbstraetThis study was performed to determine the value of dipyridamole-yymTc-methoxy-isobutyl isonitrile perfusion (99"TC-MIBI) tomographic scintigraphy in the assessment of cardiac risk in patients being evaluated prior to combined pancreas-kidney transplantation (PKT). We performed perfusion tomographic scintigraphy using single photon emission computed tomography (SPECT) on 77 patients. The tomographic images did not show clinically relevant findings in 65 patients. In the remaining 12 patients, coronary arteriography was performed: 2 showed normal results, 4 showed no stenosis, and 6 showed significant stenosis ( 2 70 YO). Seventy-two patients underwent PKT. During the follow-up (6-48 months), there were seven cardiac events, 4 patients with significant stenosis, and 3 with nonsignificant stenosis upon coronary arteriography, and all had pathological tomographic images. yymTc-MIBI tomographic scintigraphy may be useful in identifying patients at low risk of incurring cardiac events after PKT and may, in a large group of patients, obviate the need for routine coronary angiography.

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Section: Introductionsupporting

confidence: 82%

Noninvasive assessment of cardiac risk in type I diabetic patients being evaluated for combined pancreas-kidney transplantation using dipyridamole-MIBI perfusion

Fuster¹,

Magriñá²,

Ricart³

et al. 2000

Transplant Int

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“…12 This is clinically important because the presence and extent of left ventricular ischemia predict outcome beyond that provided by coronary angiographic findings alone. 4,5,13 Accordingly, the purpose of this study was to determine whether EBCT could identify subjects with scintigraphic ischemia on the basis of CACS severity and thereby define its role as a primary screening technique for identifying subjects with a broad spectrum of CAD.…”

mentioning

confidence: 99%

“…However, currently available noninvasive techniques, such as exercise treadmill testing (ETT) and myocardial single photon emission computed tomography (SPECT), can identify only patients with advanced CAD who manifest myocardial ischemia. 1,2 Although the presence and extent of left ventricular ischemia can accurately identify individuals at high risk for cardiac events, [3][4][5][6][7][8] the low prevalence of a positive test result among asymptomatic subjects with cardiac risk factors mitigates against this approach. [7][8][9] Electron beam computed tomography (EBCT) is a new noninvasive technique that can detect coronary atherosclerosis even at its earliest stages on the basis of the presence and severity of coronary artery calcification.…”

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confidence: 99%

Severity of Coronary Artery Calcification by Electron Beam Computed Tomography Predicts Silent Myocardial Ischemia

et al. 2000

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Background-Detection of subclinical coronary artery disease (CAD) before the development of life-threatening cardiac complications has great potential clinical relevance. Electron beam computed tomography (EBCT) is currently the only noninvasive test that can detect CAD in all stages of its development and thus has the potential to be an excellent screening technique for identifying asymptomatic subjects with underlying myocardial ischemia. Methods and Results-Over 2.5 years, we prospectively studied 3895 generally asymptomatic subjects with EBCT, 411 of whom had stress myocardial perfusion tomography (SPECT) within a close (median, 17 days) time period. SPECT and exercise treadmill results were compared with the coronary artery calcium score (CACS) as assessed by EBCT. The total CACS identified a population at high risk for having myocardial ischemia by SPECT although only a minority of subjects (22%) with an abnormal EBCT had an abnormal SPECT. No subject with CACS Ͻ10 had an abnormal SPECT compared with 2.6% of those with scores from 11 to 100, 11.3% of those with scores from 101 to 399, and 46% of those with scores Ն400 (PϽ0.0001). CACS predicted an abnormal SPECT regardless of subject age or sex. Conclusions-CACS

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“…The extent of the perfusion abnormality was the single most important prognostic predictor, even when coronary angiography was performed. 20 The principal notion that myocardial perfusion abnormality or ischemia was strongly correlated with event rate has been validated even in recent studies. To estimate cardiac event risk, the recommended guidelines of blood pressure, total cholesterol, and low-density-lipoprotein cholesterol to predict coronary heart disease have been published from American Heart Association and the American College of Cardiology.…”

Section: Event Rate In the J-access Studymentioning

confidence: 99%

Prognostic table for predicting major cardiac events based on J-ACCESS investigation

Nakajima¹

2008

Ann Nucl Med

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Objectives. The event risk of patients with coronary heart disease may be estimated by a large-scale prognostic database in a Japanese population. The aim of this study was to create a Heart Risk Table for predicting the major cardiac event rate. Methods. Using the J-ACCESS database created by a prognostic investigation involving 117 hospitals and >4000 patients in Japan, multivariate logistic regression analysis was performed. The major event rate over a 3-year period that included cardiac death, non-fatal myocardial infarction and severe heart failure requiring hospitalization was predicted by the logistic regression equation. The algorithm for calculating the event rate was simplified for creating tables. Results. Two tables were created to calculate cardiac risk by age, perfusion score category and ejection fraction with and without a presence of diabetes. A relative risk table comparing age-matched control subjects was also made. When the simplified tables were compared with the results from original logistic regression analysis, both risk values and relative risks agreed well (p<0.0001 for both). Conclusion. The Heart Risk Table was created for patients suspected of having ischemic heart disease and who underwent myocardial perfusion gated single-photon emission computed tomography. The validity of risk assessment using a J-ACCESS database should be validated in a future study.

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Independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in coronary artery disease

Abstract: In medically treated patients with coronary artery disease, exercise SPECT thallium imaging provides independent and incremental prognostic information even when catheterization data are available. The extent of the perfusion abnormality is the single most important prognostic predictor.

Cited by 338 publications

References 31 publications

Noninvasive assessment of cardiac risk in type I diabetic patients being evaluated for combined pancreas-kidney transplantation using dipyridamole-MIBI perfusion

Noninvasive assessment of cardiac risk in type I diabetic patients being evaluated for combined pancreas-kidney transplantation using dipyridamole-MIBI perfusion

Severity of Coronary Artery Calcification by Electron Beam Computed Tomography Predicts Silent Myocardial Ischemia

Prognostic table for predicting major cardiac events based on J-ACCESS investigation

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