title: Outcomes in patients with abnormal myocardial perfusion imaging and normal coronary angiogram.
abstract: A subset of subjects undergoing myocardial perfusion imaging has perfusion abnormalities that are subsequently labeled false positive based on coronary angiography. We evaluated the long-term prevalence of cardiovascular events in these patients. We retrospectively identified 48 patients who had reversible perfusion abnormalities with myocardial perfusion imaging and normal coronary angiography. Patients with known coronary artery disease, left ventricular dysfunction, valvular disease, and cardiomyopathy were excluded. Patient follow-up, conducted for at least 3 (mean interval, 7.4) years from the index myocardial perfusion imaging, was accomplished by a review of medical records and telephone interviews. Study endpoints were cardiovascular events defined as sudden cardiac death, myocardial infarction, percutaneous coronary revascularization, coronary artery bypass grafting, and cerebrovascular or peripheral revascularization. Thirty-one percent (15 of 48) of the patients had cardiovascular events. Six of the 48 patients had coronary events. These patients had abnormal myocardial perfusion imaging and normal coronary angiogram. The time between myocardial perfusion imaging and coronary event was 0.5 to 8.67 years. There was a strong correlation between the regions of original perfusion abnormality and the ultimate coronary ischemia or revascularization. Abnormal findings on myocardial perfusion imaging may predict a higher prevalence of coronary and peripheral vascular events than suggested by a normal coronary angiogram.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA.
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Delcour
authors.forename: Azamuddin
authors.initials: A
authors.lastname: Khaja
authors.forename: Anand
authors.initials: A
authors.lastname: Chockalingam
authors.forename: Saravanan
authors.initials: S
authors.lastname: Kuppuswamy
authors.forename: Thomas
authors.initials: T
authors.lastname: Dresser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D001157:Arterial Occlusive Diseases / Q000401:mortality; D002423:Cause of Death; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality; D003326:Coronary Circulation / Q000502:physiology*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015902:Gamma Cameras; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology; D017566:Microvascular Angina / Q000000981:diagnostic imaging* / Q000401:mortality; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012307:Risk Factors; D013223:Statistics as Topic; D020521:Stroke / Q000401:mortality; D015996:Survival Rate; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes
chemical_list: D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi