title: Stress/rest myocardial perfusion scintigraphy in patients without significant coronary artery disease.
abstract: OBJECTIVE
  To define the prognostic impact of stress myocardial perfusion scintigraphy (MPS) in patients with angiographic exclusion of significant coronary artery disease.
  
  
  METHODS
  Angiographic and MPS databases were matched to define patients without significant coronary artery disease by quantitative angiography (diameter stenosis <50%) who underwent stress MPS and coronary angiography within a time period of 3 months. A total of 118 patients were identified and followed for a mean of 6.3 +/- 1.2 years for death, a composite of death, myocardial infarction, bypass surgery, or percutaneous coronary intervention [MAE]) as well as occurrence of symptoms (angina or dyspnoe class CCS II to IV). Stress and rest MPS (using (99m)Tc-MIBI or tetrofosmin) were analyzed by quantitative perfusion SPECT (QPS) for summed stress and rest scores (SSS/SRS).
  
  
  RESULTS
  There were 16 deaths, 29 MAE, and 76 patients with MAE or significant symptoms during follow-up. Significant differences in SSS were found between patients who died (9.5 +/- 6.9 vs. 5.4 +/- 5.6, P = 0.012), had MAE (8.7 +/- 7.2 vs. 5.2 +/- 5.0, P = 0.010), or had MAE or significant clinical symptoms (7.2 +/- 7.1 vs. 4.6 +/- 6.2, P = 0.042) compared to those without the respective event. Logistic regression analysis demonstrated SSS to be a predictor of death (OR = 1.074 [95% CI: 1.004-1.149], P = 0.026) and MAE (OR = 1.087 [95% CI: 1.004-1.181], P = 0.027).
  
  
  CONCLUSIONS
  In patients without significant angiographic coronary artery disease, the result of stress MPS is a predictor of long-term prognosis. Quantitative analysis of MPS allows definition of patients with a higher likelihood to develop clinical events or symptoms.
authors.affiliation: Medical Clinic I, University RWTH Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany.
authors.forename: Umar
authors.initials: U
authors.lastname: Adamu
authors.forename: Daniela
authors.initials: D
authors.lastname: Knollmann
authors.forename: Bader
authors.initials: B
authors.lastname: Almutairi
authors.forename: Wael
authors.initials: W
authors.lastname: Alrawashdeh
authors.forename: Verena
authors.initials: V
authors.lastname: Deserno
authors.forename: Felix
authors.initials: F
authors.lastname: Vogt
authors.forename: Eduard
authors.initials: E
authors.lastname: Kleinhans
authors.forename: Wolfgang M
authors.initials: WM
authors.lastname: Schäfer
authors.forename: Rainer
authors.initials: R
authors.lastname: Hoffmann
mesh_terms: D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology; D005080:Exercise Test / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000706:statistics & numerical data*; D017682:Myocardial Stunning / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011859:Radiography; D015203:Reproducibility of Results; D012146:Rest; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*
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