Prognostic value of normal exercise and adenosine (99m)Tc-tetrofosmin SPECT imaging: results from the multicenter registry of 4,728 patients.
Event rates associated with a normal or low-risk myocardial perfusion SPECT imaging study have been shown by numerous investigators to be associated with <1%/y of follow-up. Thus, the aim of this study was to evaluate the prognostic value of a normal (99m)Tc-tetrofosmin study in a geographically diverse registry of patients undergoing stress myocardial perfusion SPECT. A total of 4,728 consecutively tested patients who underwent stress (99m)Tc-tetrofosmin SPECT at 5 U.S. hospitals were included in this series.


METHODS
Patients were monitored for the occurrence of major cardiac events and hospitalizations. Uniform methods of data collection and standardized epidemiologic methods for follow-up were used at all centers. We used a risk-adjusted, Cox proportional hazards model to assess time to cardiac death.


RESULTS
Of the 4,728 patients, one third underwent adenosine stress SPECT and two thirds underwent treadmill exercise. The observed annualized survival rate for those patients with a normal (99m)Tc-tetrofosmin study was 0.6%. Similarly, excellent survival rates were noted for the male and female subsets of this population as well as for patients who could exercise and for those undergoing pharmacologic stress testing. Compared with prior published outcomes studies on stress (201)Tl or (99m)Tc-sestamibi SPECT, the overall survival rates were similar and ranged from 99.3% to 99.7%.


CONCLUSIONS
Results from this large multicenter registry provide further supportive evidence that the excellent prognosis associated with a normal SPECT scan is independent of the radiopharmaceutical used.
Shaw
Leslee J
LJ
Atlanta Cardiovascular Research Institute, Atlanta, Georgia 30342, USA. lshaw@acrionline.org
Hendel
Robert
R
Borges-Neto
Salvador
S
Lauer
Michael S
MS
Alazraki
Naomi
N
Burnette
Joy
J
Krawczynska
Elizabeth
E
Cerqueira
Manuel
M
Maddahi
Jamshid
J
D000241:Adenosine; D002423:Cause of Death; D015331:Cohort Studies; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D012042:Registries; D012307:Risk Factors; D013312:Stress, Physiological / Q000139:chemically induced; D015996:Survival Rate; D015899:Tomography, Emission-Computed, Single-Photon; D014481:United States / Q000453:epidemiology
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin; D000241:Adenosine