Erschienen in:
01.10.2013 | Original Article
12-Year outcome after normal myocardial perfusion SPECT in patients with known coronary artery disease
verfasst von:
Machiel J. M. Ottenhof, BSc, Marisa C. G. Tjong Joe Wai, BSc, Hendrik J. Boiten, BSc, Rebecca S. Korbee, BSc, Roelf Valkema, MD, PhD, Ron T. van Domburg, PhD, Arend F. L. Schinkel, MD, PhD
Erschienen in:
Journal of Nuclear Cardiology
|
Ausgabe 5/2013
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Abstract
Background
Previous studies have reported a favorable outcome of patients with normal single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). The aim of this study was to assess the very long-term prognosis of patients with known coronary artery disease (CAD) and normal SPECT MPI results.
Methods
The population consisted of 266 patients with known CAD (defined as a healed myocardial infarction and/or a previous coronary revascularization), who underwent exercise bicycle or dobutamine-atropine stress SPECT MPI and had normal perfusion during stress and at rest. End points during follow-up were all-cause mortality, cardiac mortality, and nonfatal myocardial infarction. Univariate and multivariate analyses were performed to identify predictors of long-term outcome.
Results
Follow-up was completed in 261 (98%) patients. During a median follow-up of 12 years, 94 (36%) patients died, of which 26 (10%) died due to cardiac causes, and 15 (6%) had a nonfatal myocardial infarction. The annualized mortality rate was 3.1%, annualized cardiac mortality rate was 0.9%, and the annualized event rate for cardiac death and/or nonfatal infarction was 1.2%. Independent predictors of total mortality were age, diabetes mellitus, and rate-pressure product at peak stress. Independent predictors of cardiac mortality were age, male gender, and rate-pressure product at peak stress.
Conclusion
Patients with known CAD and a normal SPECT MPI study have a favorable long-term prognosis. Clinical and stress test variables can be used to identify patients with a higher risk status.