title: Rest myocardial perfusion imaging: a valuable tool in ED.
abstract: BACKGROUND
  Acute chest pain is a frequent cause of emergency department (ED) visits. Rest myocardial perfusion imaging (RMPI) during or immediately after an episode of chest pain can provide diagnostic and prognostic information concerning acute coronary syndromes.
  
  
  OBJECTIVE
  Our purpose was to evaluate the RMPI score in risk stratification of chest pain suspected to be of cardiac ischemic origin and negative troponin assessment.
  
  
  METHODS
  Ninety-six patients without an ongoing myocardial infarction or a history of coronary artery disease and in whom RMPI was performed in the ED because of chest pain suspected to be related with acute myocardial ischemia were included. Follow-up was performed considering the occurrence of death, myocardial infarction, or revascularization in a 12-month period admission.
  
  
  RESULTS
  Fourteen (14.6%) patients had events. According to survival analysis, the variables related with events were a history of angina (hazard ratio [HR], 4.5; P ≤ .01), an ischemic electrocardiogram (HR, 4.0; P ≤ .01), the abnormal RMPI (HR, 11.4; P ≤ .05), and the RMPI score (HR, 1.1; P ≤ .0001). When the variables of interest were forced into a multivariate model, the χ(2) associated with the model that includes clinical and electrocardiogram information was 16.3 (P ≤ .005) and in the model that also includes RMPI score, it was 23.0 (P ≤ .0005).
  
  
  CONCLUSIONS
  In a low- to intermediate-risk group of patients with suspected acute myocardial ischemia, RMPI gives not only diagnostic information but adds prognostic value to the traditional ED risk stratification tools.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Coimbra University Coimbra Hospital and University Center, Coimbra, Portugal; Department of Cardiology, Coimbra Hospital and University Center, Coimbra, Portugal. Electronic address: mjvidigal@netc.pt.
authors.forename: Maria João Vidigal
authors.initials: MJ
authors.lastname: Ferreira
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Cunha
authors.forename: Anabela
authors.initials: A
authors.lastname: Albuquerque
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Moreira
authors.forename: Gracinda
authors.initials: G
authors.lastname: Costa
authors.forename: João
authors.initials: J
authors.lastname: Lima
authors.forename: Mariano
authors.initials: M
authors.lastname: Pego
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D000368:Aged; D002637:Chest Pain / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D015331:Cohort Studies; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D019210:Troponin I / Q000097:blood
chemical_list: D019210:Troponin I