title: Usefulness of the novel risk estimation software, Heart Risk View, for the prediction of cardiac events in patients with normal myocardial perfusion SPECT.
abstract: BACKGROUND
  Myocardial perfusion single-photon emission-computed tomography (SPECT) can predict cardiac events in patients with coronary artery disease with high accuracy; however, pseudo-negative cases sometimes occur. Heart Risk View, which is based on the prospective cohort study (J-ACCESS), is a software for evaluating cardiac event probability.
  
  
  OBJECTIVE
  We examined whether Heart Risk View was useful to evaluate the cardiac risk in patients with normal myocardial perfusion SPECT (MPS).
  
  
  RESULTS
  We studied 3461 consecutive patients who underwent MPS to detect myocardial ischemia and those who had normal MPS were enrolled in this study (n = 698). We calculated cardiac event probability by Heart Risk View and followed-up for 3.8 ± 2.4 years. The cardiac events were defined as cardiac death, non-fatal myocardial infarction, and heart failure requiring hospitalization. During the follow-up period, 21 patients (3.0 %) had cardiac events. The event probability calculated by Heart Risk View was higher in the event group (5.5 ± 2.6 vs. 2.9 ± 2.6 %, p < 0.001). According to the receiver-operating characteristics curve, the cut-off point of the event probability for predicting cardiac events was 3.4 % (sensitivity 0.76, specificity 0.72, and AUC 0.85). Kaplan-Meier curves revealed that a higher event rate was observed in the high-event probability group by the log-rank test (p < 0.001).
  
  
  CONCLUSIONS
  Although myocardial perfusion SPECT is useful for the prediction of cardiac events, risk estimation by Heart Risk View adds more prognostic information, especially in patients with normal MPS.
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan. sakatani@koto.kpu-m.ac.jp.
authors.forename: Tomohiko
authors.identifier: http://orcid.org/0000-0002-0860-9457
authors.initials: T
authors.lastname: Sakatani
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shimoo
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Takamatsu
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kyodo
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Yumika
authors.initials: Y
authors.lastname: Tsuji
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Mera
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Koide
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Isodono
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Tsubakimoto
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Matsuo
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-tyo, Kamigyo-ku, Kyoto, 602-8026, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujita
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055414:Myocardial Perfusion Imaging; D018570:Risk Assessment / Q000379:methods*; D012984:Software; D015899:Tomography, Emission-Computed, Single-Photon
keywords: 99mTc-tetrofosmin myocardial perfusion SPECT; Heart Risk View; Risk estimation