[Variables that influence the indication of a second myocardial perfusion gated-SPECT after a normal stress-rest gated SPECT].
OBJECTIVE
The objective of this study was to investigate predictor variables at the moment of normal stress-rest myocardial perfusion gated SPECT for indication of a second gated SPECT.


METHODS
A prospective, single center cohort study was conducted. We evaluated 2326 consecutive patients (age 63.6 ± 13 years, 57.3% females) without perfusion defects and with normal left ventricular ejection fraction on a myocardial perfusion gated SPECT. Clinical and stress test variables were studied to predict indication of a second gated SPECT and presence of reversible perfusion defects in the second gated SPECT.


RESULTS
During a mean follow-up of 3.6 ± 2 years a second gated SPECT was performed in 286 patients (12.3%). Independent predictor variables of a second gated SPECT were presence of three or more cardiovascular risk factors (χ(2): 5.510; HR: 1.4; p=0.019), previous acute myocardial infarction (χ(2): 3.867; HR: 1.4; p=0.049), previous coronary revascularization (χ(2): 41.081; HR: 2.5; p<0.001), and a positive stress test (χ(2): 8.713; HR: 1.5; p=0.003). Observation of perfusion defects in the 280 patients in whom a second stress-rest gated SPECT was performed was more likely in male patients (χ(2): 4.322; HR: 1.9; p=0.038) who had a first pure pharmacological gated-SPECT (χ(2): 7.182; HR: 2.6; p=0.007).


CONCLUSIONS
In patients with a first normal myocardial perfusion gated SPECT, various clinical factors and variables derived from the stress test affect the indication of a second gated SPECT and the presence of ischemia in the latter.
Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: guirom@telefonica.net.
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Romero-Farina
Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España.
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Candell-Riera
Servicio de Medicina Nuclear, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR). Universitat Autònoma de Barcelona, Barcelona, España.
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Aguadé-Bruix
Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España.
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Cuberas-Borrós
Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España.
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MN
Pizzi
Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España.
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Santos
Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España.
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de León
Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, España.
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D
García-Dorado
D000368:Aged; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000706:statistics & numerical data; D003326:Coronary Circulation; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies
Cardiopatía isquémica; Coronary artery disease.; Enfermedad coronaria.; Gated-single-photon emission computed tomography; Gated-tomografía computarizada por emisión de fotones individuales; Myocardial ischemia; Prueba de estrés; Stress test