Influence of 99mTc-tetrofosmin SPECT myocardial perfusion imaging on the prediction of future adverse cardiac events

Jain, Diwakar; Lessig, Harry J.; Patel, Riti; Sandler, L.; Weiland, Frederick L.; Edell, Steven L.; Oates, M. Elizabeth; O’Malley-Tysko, Erin; Khutoryansky, Naum; Jacobson, Arnold F.

doi:10.1007/s12350-009-9080-2

Cited by 10 publications

(10 citation statements)

References 22 publications

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“…The prognostic value of exercise 99m Tc-tetrofosmin myocardial perfusion SPECT has been reported in previous studies with short-to-medium-term follow-up 4-10. The long-term prognostic value of exercise 99m Tc-tetrofosmin myocardial perfusion SPECT has not been defined.…”

Section: Discussionmentioning

confidence: 97%

“…Previous studies have demonstrated the prognostic value of exercise 99m Tc-tetrofosmin myocardial perfusion SPECT for the prediction of cardiac events in patients with known or suspected coronary artery disease at short-medium term follow-up 4-10. Groutars et al4 studied 246 patients who had a normal exercise thallium/ 99m Tc-tetrofosmin myocardial perfusion SPECT.…”

Section: Discussionmentioning

confidence: 99%

“…However, routine testing in asymptomatic patients is generally not recommended, and the clinical value and cost-effectiveness of routine SPECT after percutaneous coronary intervention need further investigation. Recently, Jain et al10 studied 371 patients with exercise or pharmacologic stress 99m Tc-tetrofosmin gated-SPECT. During a mean follow-up of 3.9 years, SPECT findings significantly improved accuracy of cardiac event rate prediction compared to clinical information alone.…”

Section: Discussionmentioning

confidence: 99%

“…These agents have a higher photon energy and shorter physical half-life, resulting in improved images quality and longer myocardial retention as compared to thallium 3. Multiple studies have demonstrated the value of 99m Tc-labeled tracers in conjunction with single-photon emission computed tomography (SPECT) for the diagnosis of coronary artery disease, and the estimation of medium-term prognosis 3-10. Several studies have demonstrated effective risk stratification with 99m Tc-tetrofosmin myocardial perfusion SPECT.…”

Section: Introductionmentioning

confidence: 99%

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Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography

Boiten¹,

Sijde²,

Ruitinga³

et al. 2012

Journal of Nuclear Cardiology

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BackgroundExercise 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) is a useful tool for short- and medium-term risk stratifications. Currently, the long-term prognostic application of this technique has not been evaluated.Methods and ResultsExercise 99mTc-tetrofosmin was performed in 655 consecutive patients. Ten patients who underwent revascularization <60 days after nuclear testing were excluded from the analysis. The present data are based on 638 patients with complete follow-up. An abnormal SPECT study was defined as the presence of fixed and/or reversible perfusion defects. End points were cardiac death, nonfatal infarction, and late coronary revascularization. A total of 344 (54%) patients had an abnormal SPECT study. Perfusion defects included fixed defects alone in 186 patients (29%) and reversible defects in 158 (25%) patients. During a mean follow-up of 11.0 ± 3.3 years, 174 (27%) patients died (all-cause mortality). Nonfatal myocardial infarction occurred in 76 (12%) patients, and late coronary revascularization was performed in 194 (30%) patients. Univariable and multivariable Cox proportional hazard regression analyses showed that exercise 99mTc-tetrofosmin SPECT provided prognostic information incremental to clinical data and exercise test data. Patients with a normal SPECT had a relatively favorable long-term prognosis, in contrast to patients with an abnormal study who had a significantly increased risk of cardiac events. The SPECT parameters abnormal scan, reversible defect, and summed rest score were strong predictors of long-term outcome.ConclusionExercise 99mTc-tetrofosmin myocardial perfusion SPECT has an incremental long-term prognostic value over clinical and stress test parameters for the prediction of major adverse cardiac events.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography

Boiten¹,

Sijde²,

Ruitinga³

et al. 2012

Journal of Nuclear Cardiology

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“…1,2 In this sense, exercise test and imaging have shown an incremental value beyond clinical data for prognostic purposes. [3][4][5][6] …”

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confidence: 99%

Usefulness of Exercise Test and Myocardial Perfusion–Gated Single Photon Emission Computed Tomography to Improve the Prediction of Major Events

Candell‐Riera

Ferreira‐González

Marsal

et al. 2013

Circ: Cardiovascular Imaging

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Background-The incremental prognostic value of myocardial perfusion-gated single photon emission computed tomography (MPGS) compared with exercise test has not yet been properly evaluated. Methods and Results-Five thousand six hundred seventy-two consecutive patients with known or suspected coronary disease undergoing exercise MPGS between 1997 and 2007 were included. Three-year predictive models for total death and death from cardiovascular causes or acute myocardial infarction (ie, major cardiovascular events [MCE]) were built using Cox-regression modeling, including only the clinical information. Then the exercise and MPGS information was sequentially added. The added discriminative ability of exercise test information and MPGS was assessed by net reclassification improvement and integrated discrimination improvement. The increase in predictive ability of exercise information for death and MCE was high as assessed by net reclassification improvement (0.199 and 0.263) and integrated discrimination improvement (0.042 and 0.021). The only variable of MPGS associated with total death was ejection fraction (hazard ratio, 0.84; 95% confidence interval, 0.79-0.89; P<0.001). Global stress ischemic score emerged as an additional variable associated with MCE (hazard ratio, 1.07; 95% confidence interval, 1.02-1.12; P=0.007). Adding MPGS information barely improved the prognostic value for total death (net reclassification improvement, 0.017; integrated discrimination improvement, 0.013), but it increased for MCE (net reclassification improvement, 0.122; integrated discrimination improvement, 0.033). Conclusions-Adding

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Prognostic value of automated SPECT scoring system for coronary artery disease in stress myocardial perfusion and fatty acid metabolism imaging

Nakata

Hashimoto

Matsuki

et al. 2012

Int J Cardiovasc Imaging

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Quantitative SPECT analysis contributes to the diagnostic and prognostic assessment of coronary artery disease. A novel automated scoring system (heart score view) can provide identical quantitative information to that determined by expert visual analysis. The aim of the present study is to evaluate the prognostic value of the automated SPECT scoring system when applied to stress thallium and resting beta-methyl-iodophenyl pentadecanoic acid (BMIPP) SPECT images. After a preliminary validation of the automated system by comparison with expert visual analyses, outcome data from 151 consecutive patients with suspected or known coronary artery disease without prior myocardial infarction were analyzed using automated SPECT scores on stress thallium and resting BMIPP images. The software quantified abnormalities as summed stress (SSS), summed rest and summed difference scores for stress thallium and as summed BMIPP scores (SBS). Cardiac events occurred over a period of 48 months in 29 (19.2 %) patients with diabetes mellitus, a lower left ventricular ejection fraction (LVEF) and more abnormal scores for thallium and BMIPP. Multivariate predictors of all cardiac events included diabetes mellitus and thallium SSS. The global Chi-square value was significantly increased when SSS was added to the clinical information (diabetes mellitus and LVEF). Negative predictive values of thallium SSS and SBS were almost identical at 84 % for all cardiac events and 98 % for hard cardiac events. Automatically quantified perfusion and BMIPP scores are related to cardiac events and these values can improve the risk stratification of coronary patients particularly when stress thallium imaging is combined with clinical information.

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Influence of 99mTc-tetrofosmin SPECT myocardial perfusion imaging on the prediction of future adverse cardiac events

Abstract: (99m)Tc-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.

Cited by 10 publications

References 22 publications

Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography

Long-term prognostic value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography

Usefulness of Exercise Test and Myocardial Perfusion–Gated Single Photon Emission Computed Tomography to Improve the Prediction of Major Events

Prognostic value of automated SPECT scoring system for coronary artery disease in stress myocardial perfusion and fatty acid metabolism imaging

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