title: Normal stress-only myocardial single photon emission computed tomography predicts good outcome in patients with coronary artery stenoses between 40 and 70.
abstract: OBJECTIVE
  Normal stress myocardial single photon emission computed tomography (SPECT) usually indicates good physiologic function of all coronary lesions, and also indicates a good outcome. We hypothesize that it can still predict good outcome in patients with coronary stenoses between 40 and 70%.
  
  
  METHODS
  A group of patients who underwent stress myocardial SPECT after coronary angiography were consecutively recruited in our center. Patients were eligible if they had one or more coronary stenoses between 40 and 70%. Patients with coronary stenoses greater than 50% diameter of left main or greater than 70% diameter of nonleft main epicardial vessels, and left ventricular ejection fraction less than 50% were excluded. The outcome was defined as major adverse events, including cardiac death, nonfatal myocardial infarction, and revascularization. Patients' survival curves were constructed accorded to the method of Kaplan and Meier and compared using the log-rank test.
  
  
  RESULTS
  A study cohort of 77 patients was enrolled. According to the summed stress score, 43 patients were assigned to the perfusion defect group and 34 patients were assigned to the perfusion normal group. The follow-up duration was 6.4±0.3 years. In the perfusion normal group, only one of 34 (2.9%) patients developed major adverse events. In the perfusion defect group, six of 43 (14%) developed major adverse events, P-value of 0.041.
  
  
  CONCLUSIONS
  It is safe to defer a percutaneous coronary intervention in patients with coronary stenoses between 40 and 70% and normal stress myocardial SPECT.
authors.affiliation: aDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing bDepartment of Cardiology, Longyan First Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Zhixin
authors.initials: Z
authors.lastname: Jiang
authors.forename: Yangqing
authors.initials: Y
authors.lastname: Liu
authors.forename: Chaofan
authors.initials: C
authors.lastname: Xin
authors.forename: Yanli
authors.initials: Y
authors.lastname: Zhou
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Zhongqiang
authors.initials: Z
authors.lastname: Zhao
authors.forename: Chunxiang
authors.initials: C
authors.lastname: Li
authors.forename: Dianfu
authors.initials: D
authors.lastname: Li
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology; D005080:Exercise Test; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*