title: Prognostic value of myocardial perfusion single-photon emission computed tomography for the prediction of future cardiac events in a Japanese population: a middle-term follow-up study.
abstract: BACKGROUND
  The prognostic value of rest 201Tl/stress (99m)Tc-tetrofosmin myocardial perfusion single-photon emission computed tomography (SPECT) for the prediction of future hard cardiac events, including acute myocardial infarction (AMI), unstable angina (UAP) and cardiac death, and the implications for risk stratification has not yet been defined in a Japanese population.
  
  
  RESULTS
  The 1,988 patients who underwent rest 201Tl/stress (99m)Tc-tetrofosmin SPECT were identified and followed up for the occurrence of AMI, UAP and cardiac death. The mean follow-up interval was 26.9+/-15.8 months. The 142 patients were revascularized within 60 days after SPECT and they were censored from the prognostic analysis. Summed stress score (SSS), summed rest score and summed difference score (SDS) were calculated using a 5-point scoring (Normal: 0, No uptake: 4) and a 20-segment model; 22 cases of myocardial infarction, 31 of UAP and 22 cardiac deaths occurred (1.2%, 1.7% and 1.2%, respectively). Multivariate Cox regression analysis showed that hypertension (Wald 6.37, p<0.05) and SDS (Wald 8.77, p<0.01) were independent predictors of AMI and UAP. Advanced age (Wald 16.0, p<0.001), SSS (Wald 10.9, p<0.01) and SDS (Wald 4.58, p<0.05) were independent predictors of cardiac death.
  
  
  CONCLUSIONS
  Myocardial perfusion SPECT yields prognostic information toward the identification of acute coronary syndrome and cardiac death.
authors: Department of Cardiology, Nihon University School of Medicine, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan.
authors: Naoya
authors: N
authors: Matsumoto
authors: Yuichi
authors: Y
authors: Sato
authors: Yasuyuki
authors: Y
authors: Suzuki
authors: Taeko
authors: T
authors: Kunimasa
authors: Shunichi
authors: S
authors: Yoda
authors: Jun
authors: J
authors: Iida
authors: Yoshimochi
authors: Y
authors: Nakano
authors: Akihiro
authors: A
authors: Yoshimura
authors: Takaaki
authors: T
authors: Miki
authors: Masahiko
authors: M
authors: Kato
authors: Shinro
authors: S
authors: Matsuo
authors: Satoshi
authors: S
authors: Saito
authors: Atsushi
authors: A
authors: Hirayama
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging*; D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging*; D016757:Death, Sudden, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*