Prognostic value of exercise cardiac tomography performed late after percutaneous coronary intervention in symptomatic and symptom-free patients.
The long-term prognostic value of single-photon emission computed tomography (SPECT) performed late after percutaneous coronary intervention (PCI) has not been extensively evaluated. Moreover, the role of myocardial ischemia at SPECT in symptom-free patients after PCI is not clear. This study was designed to determine the long-term prognostic value of SPECT in predicting cardiac events after PCI in symptomatic and symptom-free patients. Exercise technetium-99m sestamibi SPECT was performed in 206 patients between 12 and 18 months after PCI. All patients were followed for a mean period of 37 +/- 16 months. Cardiac death, nonfatal myocardial infarction, and late revascularization procedures were considered to be events. Myocardial ischemia at SPECT was detectable in 44 patients. During follow-up, 24 patients experienced events (cardiac death in 4 patients, myocardial infarction in 10, and late revascularization in 10). At univariate analysis, the summed stress score (p <0.05) and summed difference score (p <0.001) were significant predictors of cardiac events. Event-free survival curves showed a higher event rate in patients with than without ischemia (p <0.001). The occurrence of cardiac events was higher in the presence of ischemia at SPECT in symptomatic and symptom-free patients (both p <0.001). The results of this study demonstrate that the extent and severity of myocardial ischemia at exercise SPECT performed between 12 and 18 months after PCI predicts cardiac events during long-term follow-up in symptomatic and symptom-free patients.
Acampa
Wanda
W
Department of Biomorphological and Functional Sciences, Institute of Biostructures and Bioimaging of the National Council of Research, Naples, Italy.
Petretta
Mario
M
Florimonte
Luigia
L
Mattera
Angela
A
Cuocolo
Alberto
A
D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011379:Prognosis; D011446:Prospective Studies; D015899:Tomography, Emission-Computed, Single-Photon