title: Prediction of future cardiac events using myocardial perfusion SPECT: a middle-term follow-up study.
abstract: BACKGROUND
  Myocardial perfusion imaging (MPI) provides highly valuable information for risk stratification and determination of optimal clinical management. The goal of the present study was to assess the prognostic value of myocardial perfusion SPECT for the prediction of future cardiac events in Asian population.
  
  
  METHODS
  Five hundred and ten consecutive patients, who had undergone myocardial perfusion SPECT between 2005 and 2006, were prospectively followed-up. Patients' data were collected from recorded files. Follow-ups were performed by scripted telephone interviews by a physician blinded to the patients' MPI results and also from the hospital records. The total completed follow-ups consisted of 482 patients (follow-up rate, 94.5%).
  
  
  RESULTS
  Over the mean follow-up period of 434 ± 62 days, 14 out of 482 patients (2.9%) died from cardiac events. Also in 61 patients (12.7%), the clinical condition led to a cardiac intervention (Percutaneous coronary intervention or coronary artery bypass grafting). Those patients without cardiac events on follow-up (including cardiac death or myocardial infarction) were younger and with less severity of MPI abnormalities. Severe MPI abnormalities (Summed Stress Score > 13) were found in 42.9% of those with cardiac death, while in 17.2% of those with myocardial infarction. The rate of cardiac death had a direct relationship with the severity of scan abnormalities, however, the same association was not found between the severity of MPI abnormality and the rate of myocardial infarction.
  
  
  CONCLUSIONS
  MPI is a valuable tool for risk stratification and prediction of future fatal cardiac events in Asian population. The risk of cardiac death as a mid-term outcome of coronary artery disease increases significantly with severity of MPI abnormalities.
authors.affiliation: Department of Nuclear Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: S M
authors.initials: SM
authors.lastname: Modarres Mosalla
authors.forename: N
authors.initials: N
authors.lastname: Rezaei
authors.forename: H
authors.initials: H
authors.lastname: Tavakoli
authors.forename: A
authors.initials: A
authors.lastname: Gholamrezanezhad
mesh_terms: D000328:Adult; D000368:Aged; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D002637:Chest Pain / Q000453:epidemiology; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality; D055414:Myocardial Perfusion Imaging; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016037:Single-Blind Method; D012907:Smoking / Q000453:epidemiology