Incremental prognostic power of single-photon emission computed tomographic myocardial perfusion imaging in patients with known or suspected coronary artery disease

被引:32
作者
Borges-Neto, S
Shaw, LK
Tuttle, RH
Alexander, JH
Smith, WT
Chambless, M
Coleman, RE
Harrington, RA
Califf, RM
机构
[1] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA
[2] Duke Univ, Med Ctr, Dept Cardiol, Durham, NC USA
[3] Duke Univ, Med Ctr, Dept Radiol, Durham, NC 27710 USA
[4] Duke Univ, Med Ctr, Dept Nucl Med, Durham, NC USA
[5] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA
关键词
D O I
10.1016/j.amjcard.2004.09.004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Noninvasive stress testing provides prognostic information in patients who have suspected coronary artery disease, but limited data are available on the incremental value of myocardial perfusion testing in high-risk patients. We studied 3,275 patients who underwent cardiac catheterization and single-photon emission computed tomographic (SPECT) perfusion imaging. Median follow-up was 3.1 years for death, cardiovascular death, and a composite of cardiovascular death or non-fatal myocardial infarction. Using Cox's proportional hazards regression models, we examined the relation of SPECT summed stress score (SSS) to each outcome. A 1-unit change in SSS was associated with increased risks of 4%, 7%, and 5% for death, cardiovascular death, and death or nonfatal myocardial infarction, respectively (all p <0.0001). To examine the prognostic utility of SPECT, after baseline adjustments, SSS and angiographic results provided incremental prognostic information for each outcome. Thus, SPECT SSS provides information beyond clinical and angiographic data in patients who have known or suspected coronary artery disease. This information may be useful for stratifying patients into multiple risk categories for future cardiovascular events and potentially guiding therapy. (C) 2005 by Excerpta Medica Inc.
引用
收藏
页码:182 / 188
页数:7
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