title: Usefulness of stress myocardial perfusion imaging for evaluating asymptomatic patients after coronary stent implantation.
abstract: BACKGROUND
  Stent implantation in coronary angioplasty has reduced the rate of restenosis, but many patients still undergo follow-up coronary angiography (CAG). The present study was a multi-center retrospective analysis of the usefulness of stress single photon emission computed tomography (SPECT) compared with follow-up CAG in stent-implanted patients who remained asymptomatic during the follow-up period.
  
  
  RESULTS
  The study group of 103 patients underwent both SPECT and CAG at 4-9 months after stent implantation. Restenosis occurred in 20 (19%) of 106 vessel territories, and a reversible perfusion defect was found in 32 (30%) territories. Sensitivity, specificity, positive and negative predictive values, and accuracy of SPECT were 65%, 78%, 41%, 91%, and 76%, respectively. The accuracy was lower in territories with a prior myocardial infarction (71%), in the left circumflex artery (58%), and in cases with three-vessel disease (63%). The negative predictive value was high, but 7 false negative cases included 4 cases with prior myocardial infarction, and 2 cases with reversible defects in other vessel territories.
  
  
  CONCLUSIONS
  Stress SPECT imaging is a useful tool for following up patients with coronary stent implantation, and follow-up CAG could be omitted in patients with negative SPECT imaging, no prior myocardial infarction, one- or two-vessel disease, and sufficient stress loading.
authors.affiliation: Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sugi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Satoh
authors.forename: Akihiko
authors.initials: A
authors.lastname: Uehara
authors.forename: Hideki
authors.initials: H
authors.lastname: Katoh
authors.forename: Hajime
authors.initials: H
authors.lastname: Terada
authors.forename: Masaki
authors.initials: M
authors.lastname: Matsunaga
authors.forename: Keisuke
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Matoh
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Nakano
authors.forename: Shu
authors.initials: S
authors.lastname: Yoshihara
authors.forename: Chinori
authors.initials: C
authors.lastname: Kurata
authors.forename: Haruo
authors.initials: H
authors.lastname: Miyata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ukigai
authors.forename: Kei
authors.initials: K
authors.lastname: Tawarahara
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kimura
authors.forename: Shingo
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hideharu
authors.initials: H
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003326:Coronary Circulation; D003327:Coronary Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000175:diagnosis*; D005080:Exercise Test; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015607:Stents; D015899:Tomography, Emission-Computed, Single-Photon