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.
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.
Matsumoto
Naoya
N
Department of Cardiology, Nihon University School of Medicine, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan.
Sato
Yuichi
Y
Suzuki
Yasuyuki
Y
Kunimasa
Taeko
T
Yoda
Shunichi
S
Iida
Jun
J
Nakano
Yoshimochi
Y
Yoshimura
Akihiro
A
Miki
Takaaki
T
Kato
Masahiko
M
Matsuo
Shinro
S
Saito
Satoshi
S
Hirayama
Atsushi
A
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*