Long-term prognostic value of 201Tl single-photon emission computed tomographic myocardial perfusion imaging after coronary stenting.
BACKGROUND
The prognostic value of (201)Tl myocardial imaging has been demonstrated in several studies concerning patients with a known significant coronary artery disease. However, the evolution of a coronary stenosis after stenting is difficult to predict. This study was designed to assess the prognostic value of (201)Tl single-photon emission computed tomography (thallium SPECT) perfusion imaging in patients after intracoronary stenting.


METHODS
One hundred fifty-two patients were studied. They were followed up during 40 +/- 13 (mean +/- SD) months after thallium SPECT. Stent-related events were studied after thallium stress testing and included cardiovascular death, myocardial infarction, and revascularization. Stress thallium imaging was performed 5 +/- 2 months after stenting, and ischemia was considered to be present if at least 2 contiguous segments were showing reversible defects.


RESULTS
Only 3 (3%) among the 105 nonischemic patients had major cardiac events during the follow-up versus 13 (28%) of the 47 ischemic patients (P < .001) after thallium SPECT. The relative risk of major cardiac events for patients with significant ischemia was 10.5 compared with nonischemic patients (P < .001). Fourteen (30%) of the ischemic patients and 8 (8%) among the nonischemic patients underwent iterative revascularization (P < .001). Therefore, only 11 (10%) of the nonischemic patients had major cardiac events or revascularization compared with 24 (51%) of the ischemic patients (P < .001).


CONCLUSIONS
Absence of ischemia on thallium SPECT imaging at 5 months after coronary stenting indicates a low risk for cardiovascular events or interventional procedure. These results may have important clinical implications in patient treatment.
Cottin
Y
Y
Cardiology Department, Centre Hospitalier Universitaire, Dijon, France. yves.cottin@chu-dijon.fr
Rezaizadeh
K
K
Touzery
C
C
Barillot
I
I
Zeller
M
M
Prevot
S
S
L'huillier
I
I
Ressencourt
O
O
André
F
F
Fraison
M
M
Louis
P
P
Brunotte
F
F
Wolf
J E
JE
D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D018572:Disease-Free Survival; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015607:Stents; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes