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- Title
The additive prognostic value of coronary calcium score (CCS) to single photon emission computed tomography myocardial perfusion imaging (SPECT-MPI)-real world data from a single center.
- Authors
Sharma, Vinoda; Mughal, Lal; Dimitropoulos, Gerasimos; Sheikh, Awais; Griffin, Michael; Moss, Alexandra; Notghi, Alp; Pandit, Manish; Connolly, Derek L; Varma, Chetan; Kirchhof, Paulus
- Abstract
<bold>Aims: </bold>Single-photon emission computed tomography myocardial perfusion imaging [SPECT-MPI] is a functional test for coronary ischemia. We aimed to assess the additive prognostic value of coronary calcium score (CCS) to SPECT-MPI in stable patients.<bold>Methods: </bold>This study is a retrospective analysis of 655 patients who underwent SPECT-MPI with CCS (2012 to 2017). Receiver operator characteristic (ROC) identified CCS cutoff value for all-cause mortality: CCS+ if > cutoff value and MPI+ if ≥ 5% total perfusion defect (TPD). Patients were divided into 1 MPI-/CCS-; 2 MPI+/CCS-; 3 MPI-/CCS+; 4 MPI+/CCS+ and compared. Cox proportional hazard analysis identified predictors of mortality.<bold>Results: </bold>CCS cutoff for all-cause mortality was > 216 (C statistic 0.756, P < 0.0001). In MPI+ groups, mean TPD was similar (13.4% and 13.1% respectively) but mortality was higher in the CCS+ (12.5% vs. 4.8%, P = 0.22) as was the severe LV systolic dysfunction (8.0% vs. 0%, P = 0.095). In MPI- groups, mean TPD was similar (0.7% and 0.9% respectively) but all-cause mortality was higher in the CCS+ (10.7% vs. 1.6%, P < 0.0001) as was severe LVSD (2.9 % vs. 0.3% P = 0.016). Age, smoking, renal impairment ,and CCS > 216 were independent predictors of mortality.<bold>Conclusions: </bold>Patients with raised CCS on SPECT-MPI have increased mortality and poor LV function despite a negative MPI.
- Subjects
PREDICTIVE tests; MORTALITY; ARTHRITIS Impact Measurement Scales; RETROSPECTIVE studies; PROGNOSIS; CORONARY artery disease; HEART function tests; CALCIUM
- Publication
Journal of Nuclear Cardiology, 2021, Vol 28, Issue 5, p2086
- ISSN
1071-3581
- Publication type
journal article
- DOI
10.1007/s12350-019-01965-9