Long-term prognostic value of low-dose normal stress-only myocardial perfusion imaging by wide beam reconstruction: A competing risk analysis.
Aged
Algorithms
Coronary Artery Disease
/ diagnostic imaging
Exercise Test
Female
Follow-Up Studies
Heart
/ diagnostic imaging
Humans
Image Processing, Computer-Assisted
/ methods
Incidence
Male
Middle Aged
Myocardial Infarction
Myocardial Perfusion Imaging
Myocardial Revascularization
Perfusion
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Surveys and Questionnaires
Technetium Tc 99m Sestamibi
Tomography, Emission-Computed, Single-Photon
/ methods
MPI
SPECT
diagnostic and prognostic application
Journal
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
ISSN: 1532-6551
Titre abrégé: J Nucl Cardiol
Pays: United States
ID NLM: 9423534
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
16
05
2018
accepted:
10
07
2018
pubmed:
22
7
2018
medline:
10
8
2021
entrez:
21
7
2018
Statut:
ppublish
Résumé
A normal stress myocardial perfusion single-photon emission computed tomography (MPS) is associated with a good clinical outcome. New iterative algorithms, such as wide beam reconstruction (WBR), which improve image interpretation with half-dose or half-time acquisition, have been proposed for cardiac MPS. The aim of this study was to assess the long-term predictive value of a low-dose normal stress-only MPS with WBR using conventional Anger camera in patients with known or suspected coronary artery disease (CAD). A total of 2106 patients with known or suspected CAD and normal perfusion at half-dose stress-only MPS protocol were followed for a mean of 6.6 ± 2.7 years. MPS data were reconstructed with WBR iterative algorithm. End-point events were cardiac death or nonfatal myocardial infarction. Noncardiac death was considered the competing event. During follow-up, 149 cardiac events occurred with an annualized event rate of 1.2%. Independent predictors of cardiac events at Cox analysis were age, male gender, diabetes mellitus, previous myocardial infarction and the need for pharmacologic stress testing. At Fine-Gray analysis the cumulative incidence of cardiac events progressively increases with age and in the presence of diabetes for any combination of gender and stress type. Survival tree analysis confirmed that long-term prognosis considerably varies according of risk factors profile. Low-dose normal stress-only WBR MPS has a reliable long-term prognostic value in patients with suspected or known CAD. This finding supports the introduction of such a method into clinical practice with a consistent dose optimization in the interest of patients and exposed staff.
Sections du résumé
BACKGROUND
A normal stress myocardial perfusion single-photon emission computed tomography (MPS) is associated with a good clinical outcome. New iterative algorithms, such as wide beam reconstruction (WBR), which improve image interpretation with half-dose or half-time acquisition, have been proposed for cardiac MPS. The aim of this study was to assess the long-term predictive value of a low-dose normal stress-only MPS with WBR using conventional Anger camera in patients with known or suspected coronary artery disease (CAD).
METHODS AND RESULTS
A total of 2106 patients with known or suspected CAD and normal perfusion at half-dose stress-only MPS protocol were followed for a mean of 6.6 ± 2.7 years. MPS data were reconstructed with WBR iterative algorithm. End-point events were cardiac death or nonfatal myocardial infarction. Noncardiac death was considered the competing event. During follow-up, 149 cardiac events occurred with an annualized event rate of 1.2%. Independent predictors of cardiac events at Cox analysis were age, male gender, diabetes mellitus, previous myocardial infarction and the need for pharmacologic stress testing. At Fine-Gray analysis the cumulative incidence of cardiac events progressively increases with age and in the presence of diabetes for any combination of gender and stress type. Survival tree analysis confirmed that long-term prognosis considerably varies according of risk factors profile.
CONCLUSIONS
Low-dose normal stress-only WBR MPS has a reliable long-term prognostic value in patients with suspected or known CAD. This finding supports the introduction of such a method into clinical practice with a consistent dose optimization in the interest of patients and exposed staff.
Identifiants
pubmed: 30027504
doi: 10.1007/s12350-018-1373-x
pii: 10.1007/s12350-018-1373-x
doi:
Substances chimiques
Technetium Tc 99m Sestamibi
971Z4W1S09
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
547-557Commentaires et corrections
Type : CommentIn
Références
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