title: Myocardial perfusion imaging with 13N-ammonia PET is a strong predictor for outcome.
abstract: OBJECTIVE
  The aim of the present study was to assess the long-term predictive value of myocardial perfusion imaging (MPI) with (13)N-ammonia positron emission tomography (PET) in patients with suspected myocardial perfusion abnormality. At present, outcome data on the predictive value of MPI in (13)N-ammonia PET exist only for rather small patient populations.
  
  
  METHODS
  Cardiac perfusion was assessed in 943 consecutive patients using (13)N-ammonia PET, and follow-up was obtained in 698 (74%). 77 patients who underwent early revascularization (<60 days) were excluded and 621 patients were assigned to normal versus abnormal perfusion for outcome analysis. Hard events (cardiac death and non-fatal myocardial infarction) and major adverse cardiac events (MACE; hard events, hospitalization for cardiac reasons and late revascularization) were investigated using the Kaplan-Meier method. Independent predictors for various cardiac events were identified using Cox proportional hazard regression analysis.
  
  
  RESULTS
  During follow-up (5.7 ± 2.5 years), 275 patients had at least 1 cardiac event, including 102 cardiac deaths and 33 non-fatal myocardial infarction. Abnormal perfusion (n=469) was associated with a higher incidence of MACE (P<0.001) and hard events (P<0.001) throughout the 10-year follow-up period.
  
  
  CONCLUSIONS
  Cardiac perfusion findings in (13)N-ammonia PET are strong predictors of long-term outcome.
authors.affiliation: Department of Radiology, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Fiechter
authors.forename: Cathérine
authors.initials: C
authors.lastname: Gebhard
authors.forename: Jelena R
authors.initials: JR
authors.lastname: Ghadri
authors.forename: Tobias A
authors.initials: TA
authors.lastname: Fuchs
authors.forename: Aju P
authors.initials: AP
authors.lastname: Pazhenkottil
authors.forename: René N
authors.initials: RN
authors.lastname: Nkoulou
authors.forename: Bernhard A
authors.initials: BA
authors.lastname: Herzog
authors.forename: Ulrich
authors.initials: U
authors.lastname: Altorfer
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
mesh_terms: D000368:Aged; D000641:Ammonia; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009590:Nitrogen Radioisotopes; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D009590:Nitrogen Radioisotopes; D000641:Ammonia