title: Prognosis in patients with suspected or known ischemic heart disease and normal myocardial perfusion: long-term outcome and temporal risk variations.
abstract: BACKGROUND
  The prognostic value of a normal myocardial perfusion scintigraphy (MPS) may be well described, but long-term follow-up data are sparse, and temporal variations in risk are insufficiently elucidated.
  
  
  RESULTS
  During long-term follow-up (mean 6.2 years) of 1,327 consecutive Danish patients with normal MPS, the rate of all-cause death (ACD) was 1.9%/year (differing by gender) and of cardiac death (CD)/myocardial infarction (MI) 0.8%/year (differing by coronary artery disease, CAD). Female gender (HR: 0.60), age (HR: 1.07 per-year increment), and known CAD without prior revascularization (HR: 2.17) were statistically significant factors for ACD, whereas diabetes and previous MI per se were not. Known CAD with previous revascularization carried a low risk of ACD when adjusted for gender and age (HR: 0.56). For CD/MI, risk increased with age and threefold with known CAD, previous MI, and previous percutaneous coronary intervention. Judged from smoothed hazard functions, mortality risk increased further with time for men, elderly, and diabetics and markedly further with known CAD without prior revascularization.
  
  
  CONCLUSIONS
  Following a normal MPS, rates of death and hard cardiac events were low. Risk varied with age, gender, and disease history. Novel aspects of temporal risk variation suggested a general warranty period of 5 years, but less in risk groups.
authors: Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark. jane.simonsen@ouh.regionsyddanmark.dk
authors: Jane A
authors: JA
authors: Simonsen
authors: Oke
authors: O
authors: Gerke
authors: Charlotte K
authors: CK
authors: Rask
authors: Mohammad
authors: M
authors: Tamadoni
authors: Anders
authors: A
authors: Thomassen
authors: Søren
authors: S
authors: Hess
authors: Allan
authors: A
authors: Johansen
authors: Hans
authors: H
authors: Mickley
authors: Lisette O
authors: LO
authors: Jensen
authors: Jesper
authors: J
authors: Hallas
authors: Werner
authors: W
authors: Vach
authors: Poul F
authors: PF
authors: Høilund-Carlsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009206:Myocardium / Q000473:pathology*; D010477:Perfusion; D011379:Prognosis; D016016:Proportional Hazards Models; D011877:Radionuclide Imaging; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult