Myocardial technetium-99m sestamibi single-photon emission tomography as a prognostic tool in coronary artery disease: multivariate analysis in a long-term prospective study

Zanco, Pierluigi; Zampiero, A.; Favero, A; Borsato, N; Chierichetti, Franca; Rubello, Domenico; Saitta, B.; Ferlin, G

doi:10.1007/bf00808414

Cited by 18 publications

(1 citation statement)

References 10 publications

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“…[22][23][24][25][26][27][28] Conversely, the only study addressing risk stratification with AC was by Gibson et al demonstrating the safety of a normal study mainly in a low risk group referred for chest pain. Although the current endorsement for AC by national societies is based on multiple studies demonstrating improved diagnostic accuracy for the detection of significant CAD, data providing risk stratification for this procedure are lacking.…”

Section: Discussionmentioning

confidence: 95%

Risk stratification with attenuation corrected stress Tc-99m sestamibi SPECT myocardial perfusion imaging in the absence of ECG-gating due to arrhythmias

Baghdasarian

Noble

Ahlberg

et al. 2009

Journal of Nuclear Cardiology

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Section: Discussionmentioning

confidence: 95%

Risk stratification with attenuation corrected stress Tc-99m sestamibi SPECT myocardial perfusion imaging in the absence of ECG-gating due to arrhythmias

Baghdasarian

Noble

Ahlberg

et al. 2009

Journal of Nuclear Cardiology

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Cardiovascular System

Klingensmith¹

2016

The Mathematics and Biology of the Biodistribution of Radiopharmaceuticals - A Clinical Perspective

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Long-term prognostic value of exercise 99m Tc-MIBI SPET myocardial perfusion imaging in patients after percutaneous coronary intervention

Zhang

Liu

et al. 2004

European Journal of Nuclear Medicine and Molecular Imaging

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The purpose of this study was to evaluate the long-term prognostic value of exercise technetium-99m methoxyisobutylisonitrile ((99m)Tc-MIBI) single-photon emission tomography (SPET) imaging in patients after percutaneous coronary intervention (PCI). Three hundred and eighteen consecutive post-PCI patients who underwent exercise and rest (99m)Tc-MIBI SPET myocardial perfusion imaging (MPI) were followed up for 38+/-27 months. Patients with early revascularisation (<3 months after MPI) were excluded. A semiquantitative visual analysis employing a 20-segment and four-point scoring system was used to define the summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS). Death and non-fatal myocardial infarction (MI) were considered as hard events, and late revascularisation procedures (>/=3 months after MPI) as soft events. Fifty-one patients (16.0%) suffered from cardiac events during follow-up, including 1 (0.3%) death, 13 (4.1%) non-fatal MIs, 9 (2.8%) coronary artery bypass grafting procedures and 28 (8.8%) PCIs. According to the SPET results, patients were classified into three groups: patients with normal MPI (SSS=0, n=153), patients with irreversible defects (SDS<3 and SRS>1, n=100) and patients with reversible defects (SDS>/=3, n=65). The annual hard cardiac event rate in patients with reversible defects was 3.9%, which was significantly higher than that in patients with normal MPI (0.2%, chi(2)=7.71; P<0.01). The annual soft cardiac event rate in patients with reversible defects was 10.7%, which was significantly higher than that in patients with irreversible defects (2.5% chi(2)=17.69; P<0.001), and also significantly higher than that in patients with normal MPI (1.5%, chi(2)=33.89; P<0.001). In patients with normal and reversible defects, there was no significant difference in soft and hard cardiac event rates according to whether patients were symptomatic or asymptomatic ( P>0.05). However, the annual soft event rate in patients with irreversible defects and symptoms was 5.0%, which was higher than that of 0.6% in asymptomatic patients (chi(2)=6.11, P<0.05). Multivariate Cox analysis showed that SSS was the best independent predictor for hard cardiac events (chi(2)=12.70; P<0.001) and SDS was the strongest independent predictor for soft cardiac events (chi(2)=11.72; P<0.001). Post-PCI patients who have normal exercise (99m)Tc-MIBI SPET MPI have a good long-term prognosis, while those with reversible defects are at a higher risk for future cardiac events, without correlation to the chest pain symptoms. However, symptomatic patients with irreversible defects have a higher risk for repeat revascularisation, but not for hard events, compared with asymptomatic patients. Exercise (99m)Tc-MIBI SPET MPI has important clinical value for risk stratification and management decision-making in post-PCI patients.

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Myocardial technetium-99m sestamibi single-photon emission tomography as a prognostic tool in coronary artery disease: multivariate analysis in a long-term prospective study

Cited by 18 publications

References 10 publications

Risk stratification with attenuation corrected stress Tc-99m sestamibi SPECT myocardial perfusion imaging in the absence of ECG-gating due to arrhythmias

Risk stratification with attenuation corrected stress Tc-99m sestamibi SPECT myocardial perfusion imaging in the absence of ECG-gating due to arrhythmias

Cardiovascular System

Long-term prognostic value of exercise 99m Tc-MIBI SPET myocardial perfusion imaging in patients after percutaneous coronary intervention

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