Prognostic Value of Combined Perfusion and Function by Stress Technetium-99m Sestamibi Gated SPECT Myocardial Perfusion Imaging in Patients With Suspected or Known Coronary Artery Disease

Petix, Nunzia Rosa; Sestini, Stelvio; Coppola, Angela; Marcucci, Gabriella; Nassi, Franco; Taiti, Andrea; Guarnaccia, Vincenzo; Mennuti, A; Mazzoni, Vincenzo; Zipoli, A

doi:10.1016/j.amjcard.2005.01.081

Cited by 34 publications

(18 citation statements)

References 20 publications

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“…9 Petix et al showed that during follow-up (median 13 months) of 333 patients, 17 cardiac deaths (5.1%) and 13 nonfatal acute myocardial infarctions (3.9%) occurred. 13 Although the study setting might differ among studies, the event rate was generally lower in Japan compared with those of Western studies. 6,9,10,13,14 The annual hard event rate in normal myocardial perfusion SPECT was found to be low (0.63%) in the subanalysis.…”

Section: Event Rate In the J-access Studymentioning

confidence: 98%

“…13 Although the study setting might differ among studies, the event rate was generally lower in Japan compared with those of Western studies. 6,9,10,13,14 The annual hard event rate in normal myocardial perfusion SPECT was found to be low (0.63%) in the subanalysis. 15 The importance of diabetes mellitus has been emphasized in a Japanese population, which has been also demonstrated in Western studies.…”

Section: Event Rate In the J-access Studymentioning

confidence: 98%

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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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Section: Event Rate In the J-access Studymentioning

confidence: 98%

Section: Event Rate In the J-access Studymentioning

confidence: 98%

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

Nakajima¹

2008

Ann Nucl Med

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“…The LV EF provides incremental prognostic information over perfusion in predicting cardiac death, whereas stress-induced ischemia predicts acute coronary syndromes. [7,[13][14][15] A European study by Petix et al found that the most powerful predictor of all cardiac events was the degree of myocardial ischemia, while adding ventricular function data yielded an incremental value for predicting hard events but not all events. [14] Although the settings differed among these studies, our data suggested a closer relationship between hard events and baseline LV function and between all events and both stress-induced ischemia and LV function in our population.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of myocardial perfusion and ventricular function in a Japanese multicenter cohort study (J-ACCESS): the first-year total events and hard events

Nakajima

Kusuoka

Nishimura³

et al. 2009

Ann Nucl Med

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Objective To determine the prognostic value of myocardial ischemia, function and coronary risk factors on total and hard cardiac events using myocardial perfusion imaging in a Japanese population.Methods A prospective cohort study was performed in 117 Japanese hospitals, each with a nuclear cardiology facility. A total of 4,031 patients with suspected or confirmed ischemic heart disease were registered. The patients were followed up for a year to investigate total and hard events, and those who had any events were followed up for 3 years to evaluate subsequent hard events. A stress-rest gated myocardial perfusion study was performed with 99m Tc-tetrofosmin using gated singlephoton-emission computed tomography (SPECT) and analyzed by semi-quantitative scores.Results During the one-year follow-up period, 263 (6.5%) patients had total events comprising all-cause death, non-fatal myocardial infarction (MI), heart failure, unstable angina, angina pectoris and coronary revascularization. Cardiac death occurred in 23 patients (0.6%) and non-fatal MI in 11 (0.3%). Among patients with ejection fraction (EF) of <45% and a summed difference score (SDS) of ≥2, 18.7% (2.4% for cardiac death and 0.6% for non-fatal MI) experienced total events compared with 3.9% (0.3% for cardiac death and 0.2% for non-fatal MI; p <0.0001) of those with EF ≥45% and SDS <2. Multivariate analysis identified EF, SDS, age, history of revascularization and diabetes as significant predictors of all events, while the significant predictors were age and EF for hard events. When the patients who had heart failure in the first year were followed up, 9 of 41 (22.0%) experienced cardiac death in the subsequent three-year follow-up period. ConclusionMyocardial ischemia defined by SDS and ventricular function were the main predictors of total events despite the relatively low incidence of hard events in this Japanese population. In patients with cardiac events in a year, closer attention should be paid to subsequent hard events particularly in patients with heart failure.

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“…6 Although such patients may be further stratified by anatomical tests such as invasive or CT coronary angiography, patients with a normal study can usually be reassured without the need for further testing. Those with abnormal MPS have a seven-fold higher annual risk of myocardial infarction and death compared with those with normal studies 7 and the coronary event rate increases with ischemic burden. 6 Virtually every modern test for myocardial ischemia has been validated at some stage against SPECT.…”

Section: Introductionmentioning

confidence: 99%

PET should not replace routine SPECT MPS for the assessment of patients with known or suspected CAD

Stirrup

Underwood

2017

Journal of Nuclear Cardiology

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Prognostic Value of Combined Perfusion and Function by Stress Technetium-99m Sestamibi Gated SPECT Myocardial Perfusion Imaging in Patients With Suspected or Known Coronary Artery Disease

Cited by 34 publications

References 20 publications

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

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

Prognostic value of myocardial perfusion and ventricular function in a Japanese multicenter cohort study (J-ACCESS): the first-year total events and hard events

PET should not replace routine SPECT MPS for the assessment of patients with known or suspected CAD

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