title: Prognostic Implications of Discordant Results of Myocardial Perfusion Single-Photon Emission Computed Tomography and Exercise ECG Test in Patients with Stable Angina.
abstract: BACKGROUND
  ECG exercise treadmill test (ExT) and myocardial perfusion SPECT (single photon emission computed tomography) study are widely used for the non-invasive evaluation of patients with coronary artery disease (CAD).
  
  
  OBJECTIVE
  To assess long-term prognosis in patients with suspected or known coronary artery disease (CAD), in whom ECG exercise treadmill test (ExT) and myocardial perfusion single photon emission computed tomography (SPECT) provided discordant results are lacking.
  
  
  METHODS
  Four hundred eighty three patients with suspected or known stable CAD underwent 99mTc-methoxyisobutylisonitrile SPECT and ExT. SPECT was considered positive (+) if inducible or mixed perfusion defects were detected. ExT was evaluated using widely accepted criteria. Based on the results of both examinations the patients were divided into 4 subgroups: group 1 - SPECT (+) and ExT (+), group 2 - SPECT (+) and ExT (-), group 3 - SPECT (-) and ExT (+), group 4 - SPECT (-) and ExT (-).
  
  
  RESULTS
  After a mean follow-up of 59 ± 7 months, major cardiac events (cardiac death and nonfatal myocardial infarction combined) and revascularizations were more prevalent in groups 1 and 2 than in groups 3 and 4. However, the statistical significance (p ≤ 0.01) was reached only for the following differences: in major cardiac events - group 1 vs group 3 and group 1 vs group 4; in revascularizations - group 1 vs. group 3, group 1 vs. group 4 and group 2 vs group 4 and in cardiac hospitalizations - group 1 vs. group 4 and group 2 vs. group 4.
  
  
  CONCLUSIONS
  Positive myocardial perfusion SPECT result is associated with similar clinical outcome irrespectively of ExT result in long-term follow-up.
authors.affiliation: Department of Cardiology, Medical University of Lodz, Poland.
authors.forename: Ewelina
authors.initials: E
authors.lastname: Kowalczyk
authors.affiliation: Department of Cardiology, Medical University of Lodz, Poland.
authors.forename: Dominika
authors.initials: D
authors.lastname: Filipiak-Strzecka
authors.affiliation: Department of Cardiology, Medical University of Lodz, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Hamala
authors.affiliation: Department of Cardiology, Medical University of Lodz, Poland.
authors.forename: Nina
authors.initials: N
authors.lastname: Śmiech
authors.affiliation: Department of Cardiology, Medical University of Lodz, Poland.
authors.forename: Jarosław D
authors.initials: JD
authors.lastname: Kasprzak
authors.affiliation: Department of Nuclear Medicine, Medical University of Lodz, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Kuśmierek
authors.affiliation: Department of Nuclear Medicine, Medical University of Lodz, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Płachcińska
authors.affiliation: Department of Cardiology, Medical University of Lodz, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Lipiec
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D003326:Coronary Circulation; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi