Prognostic Value of Myocardial Perfusion Single-Photon Emission Computed Tomography for the Prediction of Future Cardiac Events in a Japanese Population  A Middle-Term Follow-up Study

Matsumoto, Naoya; Sato, Yuichi; Suzuki, Yasuyuki; Kunimasa, Taeko; Yoda, Shunichi; Iida, Joji; Nakano, Yoshimitsu; Yoshimura, Atsushi; Miki, Takeshi; Kato, Masahiko; Matsuo, Shinro; Saito, Satoshi; Hirayama, Atsushi

doi:10.1253/circj.71.1580

Cited by 49 publications

(46 citation statements)

References 20 publications

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“…Another investigation of mid-term follow-up (average period of 26.9 months) in a hospital included a 201 Tl/ 99m Tc dual nuclide study of 1988 patients. [12] The annual event rates of cardiac death were 0.1% and 2.9% for SSS 0 -3 and > 13, respectively, and nonfatal MI and unstable angina occurred in 0.9% and 2.4% for SSS 0 -3 and > 13, respectively. Although these studies suggested a relatively low incidence of hard events, statistical analysis necessitated far more patients considering the low incidence of cardiac death.…”

Section: Discussionmentioning

confidence: 90%

Prognostic value of myocardial perfusion and ventricular function in a Japanese multicenter cohort study (J-ACCESS): the first-year total events and hard events

Nakajima

Kusuoka

Nishimura³

et al. 2009

Ann Nucl Med

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Objective To determine the prognostic value of myocardial ischemia, function and coronary risk factors on total and hard cardiac events using myocardial perfusion imaging in a Japanese population.Methods A prospective cohort study was performed in 117 Japanese hospitals, each with a nuclear cardiology facility. A total of 4,031 patients with suspected or confirmed ischemic heart disease were registered. The patients were followed up for a year to investigate total and hard events, and those who had any events were followed up for 3 years to evaluate subsequent hard events. A stress-rest gated myocardial perfusion study was performed with 99m Tc-tetrofosmin using gated singlephoton-emission computed tomography (SPECT) and analyzed by semi-quantitative scores.Results During the one-year follow-up period, 263 (6.5%) patients had total events comprising all-cause death, non-fatal myocardial infarction (MI), heart failure, unstable angina, angina pectoris and coronary revascularization. Cardiac death occurred in 23 patients (0.6%) and non-fatal MI in 11 (0.3%). Among patients with ejection fraction (EF) of <45% and a summed difference score (SDS) of ≥2, 18.7% (2.4% for cardiac death and 0.6% for non-fatal MI) experienced total events compared with 3.9% (0.3% for cardiac death and 0.2% for non-fatal MI; p <0.0001) of those with EF ≥45% and SDS <2. Multivariate analysis identified EF, SDS, age, history of revascularization and diabetes as significant predictors of all events, while the significant predictors were age and EF for hard events. When the patients who had heart failure in the first year were followed up, 9 of 41 (22.0%) experienced cardiac death in the subsequent three-year follow-up period. ConclusionMyocardial ischemia defined by SDS and ventricular function were the main predictors of total events despite the relatively low incidence of hard events in this Japanese population. In patients with cardiac events in a year, closer attention should be paid to subsequent hard events particularly in patients with heart failure.

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Section: Discussionmentioning

confidence: 90%

Prognostic value of myocardial perfusion and ventricular function in a Japanese multicenter cohort study (J-ACCESS): the first-year total events and hard events

Nakajima

Kusuoka

Nishimura³

et al. 2009

Ann Nucl Med

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“…All study participants provided written informed consent prior to inclusion in the study. Tctetrofosmin myocardial perfusion SPECT 8,[10][11][12][13][14][15][16] at Nihon University Itabashi Hospital between October 2004 and March 2013 and who had a significant stenosis with 75% or greater narrowing of the arterial diameter detected by coronary angiography (CAG) performed after confirmation of at least 5% ischemia by the SPECT. The patients underwent treatment including revascularization and medication, and thereafter, were re-evaluated with the SPECT during a chronic phase and followed up to confirm prognosis for at least one year.…”

Section: Methodsmentioning

confidence: 99%

“…Risk stratification of cardiac events by nuclear cardiology has been demonstrated in some large-scale prognostic studies including the multicenter prospective Japanese Assessment of Cardiac Events and Survival Study in patients with ischemic heart disease (J-ACCESS), 5) in asymptomatic patients with type 2 diabetes (J-ACCESS 2), 6) in patients with chronic kidney disease (J-ACCESS 3), 7) and in another single-center large-scale prospective study. 8) Nakajima, et al 9) published a Heart Risk Table, which is the first cardiac event risk score predicting the risk of major cardiac events (MCEs) in Japanese patients with CAD within 3 years, prepared on the basis of predictors obtained from the J-ACCESS database (n = 2,395). MCEs predicted with the Heart Risk Table, however, include severe heart failure unlike MCEs defined in non-Japanese studies.…”

Section: Tl and Stress 99mmentioning

confidence: 99%

Prognostic Value of Major Cardiac Event Risk Score Estimated With Gated Myocardial Perfusion Imaging in Japanese Patients With Coronary Artery Disease

et al. 2016

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SummaryWe published a cardiac event risk score (CERS) predicting the risk of major cardiac events (MCEs) within 3 years. The purpose of this study was to verify the prognostic value of the CERS before and after treatment in Japanese patients with coronary artery disease.We retrospectively investigated 612 patients who underwent rest 201Tl and stress 99mTc-tetrofosmin myocardial perfusion single photon emission computed tomography (SPECT) between October 2004 and March 2013 and who had a significant stenosis with ≥ 75% narrowing of the arterial diameter detected by coronary angiography performed after confirmation of ≥ 5% ischemia with the SPECT. The patients underwent treatment including revascularization and medication, and thereafter, were re-evaluated with SPECT during a chronic phase and followed-up to confirm prognosis for ≥ 1 year. The endpoint was the onset of MCEs during the follow-up.During the follow-up (36.7 ± 14.5 months), 50 patients (8.7%) experienced MCEs comprising cardiac death (n = 16), non-fatal myocardial infarction (n = 4), and unstable angina pectoris (n = 30). The multivariate Cox proportional hazards regression model analysis for the actual occurrence of MCEs showed the summed difference score % and MCE risks estimated with the CERS after treatment to be significant independent variables. Ischemic reduction after treatment contributed significantly to a decrease in the MCE risks. The MCE risks estimated with the CERS after treatment were generally consistent with the incidence of the MCEs actually observed.The CERS after treatment is a valuable formula for predicting prognosis in Japanese patients with coronary artery disease. (Int Heart J 2016; 57: 408-416)

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“…Summed stress score (SSS) from the summation of visual scoring using American heart association 17-segment model and ejection fraction derived from Quantitative gated SPECT (QGS) software are the major powerful predictor of MACE (4,5). In addition, recent clinical guideline recommends to prove ≥10% of stress induced ischemia or jeopardized myocardium in the cases of stable PCIs, which is expressed in summed difference score (SDS) (6,7).…”

Section: Quantification Of Mpimentioning

confidence: 99%

Nuclear Medicine is the Best Approach for Detecting Coronary Artery Disease

Matsumoto

Hirayama

2017

Annals of Nuclear Cardiology

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Diagnostic modalities including SPECT and CT are both useful for detecting coronary artery disease. Physiological and anatomical approaches are two sides of same coin. In a twist of irony, increasing of CT angiography and decreasing of SPECT field in Japan would be associated with in appropriate coronary interventions in terms of American appropriate use criteria of coronary interventions. Quantification of perfusion abnormality and myocardial flow reserve using dedicated CZT gamma camera would make it possible to identify the patients, in whom interventions may improve the long-term prognosis. Recent publication reported that initial non-invasive diagnostic modalities (SPECT or CT) did not affect patients' outcome. Medical economical approach should be taken into account for the selection of those two modalities in future.

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Prognostic Value of Myocardial Perfusion Single-Photon Emission Computed Tomography for the Prediction of Future Cardiac Events in a Japanese Population A Middle-Term Follow-up Study

Cited by 49 publications

References 20 publications

Prognostic value of myocardial perfusion and ventricular function in a Japanese multicenter cohort study (J-ACCESS): the first-year total events and hard events

Prognostic value of myocardial perfusion and ventricular function in a Japanese multicenter cohort study (J-ACCESS): the first-year total events and hard events

Prognostic Value of Major Cardiac Event Risk Score Estimated With Gated Myocardial Perfusion Imaging in Japanese Patients With Coronary Artery Disease

Nuclear Medicine is the Best Approach for Detecting Coronary Artery Disease

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