title: What is the prognostic value of myocardial perfusion imaging using rubidium-82 positron emission tomography?
abstract: OBJECTIVE
  The objective was to determine the prognostic value of rubidium-82 (82Rb) positron emission tomography (PET) myocardial perfusion imaging (MPI).
  
  
  BACKGROUND
  82Rb PET MPI accurately diagnoses coronary artery disease (CAD). However, there are limited data evaluating its prognostic value.
  
  
  METHODS
  Follow-up (3.1 +/- 0.9 years) was obtained in 367 patients who underwent dipyridamole 82Rb PET MPI. Patients were divided into groups based on their summed stress score (SSS): group I, normal (<4); group II, mild (4 to 7); and group III, moderate (8 to 11) to severe (> or =12).
  
  
  RESULTS
  There were significant differences among patients in the 3 SSS groups for hard events (cardiac death and myocardial infarction [MI]) (p < 0.001) and total cardiac events (hard events, revascularization and hospitalization) (p < 0.001). The annual hard events rates were 0.4%, 2.3%, and 7.0% in the normal, mild, and moderate-severe groups, respectively. In adjusted survival models, 82Rb PET SSS was the strongest predictor of total cardiac events and a significant predictor of hard events. Among patients referred for PET after 99mTc single-photon emission computed tomography, the annual total event rate was higher with abnormal versus normal SSS on PET (15.2% vs. 1.3%, p < 0.001). In patients with obesity, the annual total event rate was 11.1% with an abnormal scan and 1.5% with a normal scan (p < 0.001).
  
  
  CONCLUSIONS
  This study shows that 82Rb PET MPI has significant prognostic value for predicting cardiac events, including death and MI. It also seems to have prognostic value in patients whose diagnosis remains uncertain after single-photon emission computed tomography MPI and in obese patients. The prognostic value of PET MPI may improve the management of cardiac patients.
authors.affiliation: Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Yoshinaga
authors.forename: Benjamin J W
authors.initials: BJ
authors.lastname: Chow
authors.forename: Kathryn
authors.initials: K
authors.lastname: Williams
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.forename: Robert A
authors.initials: RA
authors.lastname: deKemp
authors.forename: Linda
authors.initials: L
authors.lastname: Garrard
authors.forename: Alexander
authors.initials: A
authors.lastname: Lok-Tin Szeto
authors.forename: May
authors.initials: M
authors.lastname: Aung
authors.forename: Ross A
authors.initials: RA
authors.lastname: Davies
authors.forename: Terrence D
authors.initials: TD
authors.lastname: Ruddy
authors.forename: Rob S B
authors.initials: RS
authors.lastname: Beanlands
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D003326:Coronary Circulation; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009765:Obesity; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012414:Rubidium Radioisotopes; D012720:Severity of Illness Index; D013667:Technetium; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D012414:Rubidium Radioisotopes; D013667:Technetium