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- Title
Risk stratification using line source attenuation correction with rest/stress Tc-99m sestamibi SPECT myocardial perfusion imaging.
- Authors
Ardestani, Afrooz; Ahlberg, Alan; Katten, Deborah; Santilli, Krista; Polk, Donna; Bateman, Timothy; Heller, Gary
- Abstract
Background: Although line source attenuation correction (AC) in SPECT MPI studies improves diagnostic accuracy, its prognostic value is less understood. Methods: Consecutive patients (n = 6,513) who underwent rest/stress AC ECG-gated SPECT MPI were followed for cardiac death or non-fatal myocardial infarction (MI). A 17-segment model and AC summed stress score (SSS) were used to classify images. Results: Of the 6,513 patients, cardiac death or non-fatal MI occurred in 267 (4.1%), over 2.0 ± 1.4 years. The AC-SSS in patients with a cardiac event (5.6 ± 7.8) was significantly higher than in those without (1.9 ± 4.6, P < .001). The annualized cardiac event rate in patients with an AC-SSS 1-3 (3.6%) was significantly higher than in those with an AC-SSS = 0 (1.1%, P < .001) but similar to that in those with an AC-SSS 4-8 (2.9%, P = .4). Accordingly, patients were classified to AC-SSS = 0, 1-8, and >8 with annualized cardiac event rates of 1.1%, 3.2%, and 8.5%, respectively ( P < .0001). In multivariate analysis, an AC-SSS 1-8 and >8 emerged as independent predictors of cardiac events ( P < .02 and P < .0001, respectively). Conclusion: Rest/stress ECG-gated SPECT MPI with line source AC provides highly effective and incremental risk stratification for future cardiac events.
- Subjects
MYOCARDIAL perfusion imaging; SINGLE-photon emission computed tomography; TECHNETIUM isotopes; ELECTROCARDIOGRAPHY; MYOCARDIAL infarction; MEDICAL statistics
- Publication
Journal of Nuclear Cardiology, 2014, Vol 21, Issue 1, p118
- ISSN
1071-3581
- Publication type
Article
- DOI
10.1007/s12350-013-9816-x