Prognostic value of predischarge dipyridamole technetium 99m sestamibi myocardial tomography in medically treated patients with unstable angina

Stratmann, Henry G.; Tamesis, Beaver R.; Younis, Liwa T.; Wittry, Mark D.; Amato, Maryellen; Miller, D. Douglas

doi:10.1016/0002-8703(95)90071-3

Cited by 47 publications

(8 citation statements)

References 22 publications

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“…Although several previous studies do not show this relationship, 21 others have, particularly if the study included a high-risk population. [22][23][24] For example, in cardiac patients with ischemic events, Miller et al 23 demonstrated similar predictive values of both fixed and reversible MPI defects. Stratmann et al 24 evaluated 285 patients before nonvascular surgery and found a fixed MPI defect was associated with a cardiac event rate of 17%, compared with a rate of 12% with a reversible defect.…”

Section: Prognostic Value Of Fixed Mpi Defectsmentioning

confidence: 96%

Impact of Diabetes on the Risk Stratification Using Stress Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging in Patients With Symptoms Suggestive of Coronary Artery Disease

et al. 2002

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Background-Coronary artery disease can develop prematurely and is the leading cause of death among diabetics, making noninvasive risk stratification desirable. Methods and Results-Patients with symptoms of coronary artery disease who were undergoing stress myocardial perfusion imaging (MPI) from 5 centers were prospectively followed (2.5Ϯ1.5 years) for the subsequent occurrence of cardiac death, myocardial infarction (MI), and revascularization. Stress MPI results were categorized as normal or abnormal (fixed or ischemic defects and 1, 2, or 3 vessel distribution

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Section: Prognostic Value Of Fixed Mpi Defectsmentioning

confidence: 96%

Impact of Diabetes on the Risk Stratification Using Stress Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging in Patients With Symptoms Suggestive of Coronary Artery Disease

et al. 2002

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“…Myocardial perfusion imaging has been widely used for the diagnosis and evaluation of coronary artery disease (CAD) [1,2,3,4,5]. However, since perfusion imaging documents relative myocardial perfusion, it has limited utility, particularly in patients with multivessel disease or diffuse CAD.…”

Section: Introductionmentioning

confidence: 99%

Estimation of myocardial blood flow and myocardial flow reserve by 99mTc-sestamibi imaging: comparison with the results of [15O]H2O PET

Ito

Katoh

Noriyasu

et al. 2003

Eur J Nucl Med Mol Imaging

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We developed a noninvasive method to quantitatively estimate the myocardial blood flow (MBF) index and flow reserve (MFR) using dynamic and static data obtained with technetium-99m sestamibi, and compared the results with MBF and MFR measured by oxygen-15-labeled water ([(15)O]H(2)O) PET. Twenty patients with coronary artery disease (CAD) and nine normal subjects underwent both (99m)Tc-sestamibi and PET studies within 2 weeks. From the anterior view, dynamic data were acquired for 2 min immediately after the injection of (99m)Tc-sestamibi, and planar static images were also obtained after 5 min at rest and during ATP stress (0.16 mg kg(-1) min(-1) for 5 min) on another day. The area under the time-activity curve on the aortic arch (Aorta ACU), myocardial weight with the SPET image (M), and the myocardial count on the planar image for 1 min (C(m)) were obtained. The MBF index (MBFI) was calculated as follows: MBFI=Cm/Aorta ACU x 100M. MFR was measured by dividing the MBFI at ATP stress by MBFI at rest. The MBFI measured by (99m)Tc-sestamibi was significantly correlated with MBF obtained using [(15)O]H(2)O PET (MBFI=13.174+11.732 x MBF, r=0.821, P<0.001). Furthermore, MFR measured by (99m)Tc-sestamibi was well correlated with that obtained using [(15)O]H(2)O PET, with some underestimation (r=0.845, P<0.001). MFR using (99m)Tc-sestamibi in patients with CAD was significantly lower than that in normal subjects (CAD: 1.484+/-0.256 vs normal: 2.127+/-0.308, P<0.001). These data suggest that the MBFI and MFR can be measured with (99m)Tc-sestamibi. This may be useful for the quantitative assessment of CAD, especially in those patients with diffuse coronary disease.

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“…In a study of 128 patients stabilized with medical therapy after presenting with unstable angina, and classified being at intermediate risk on clinical criteria, those with abnormal dipyridamole methoxyisobutylisonitrile (MIBI) scan had a 30% event rate (death or MI), whereas in patients with a normal scan, the corresponding rate was 7%. On multivariate analysis, the presence of either a reversible defect (RR 2.4) or a fixed defect (RR 3.4) exhibited an independent predictive value [46]. Risk stratification before noncardiac surgery Cardiovascular disease is a major cause of morbidity and mortality in patients undergoing noncardiac surgery, and hence there is great emphasis on risk stratification of these patients to identify those at high risk for cardiovascular events.…”

Section: Unstable Anginamentioning

confidence: 99%

Pharmacologic radionuclide myocardial perfusion imaging

Navare¹,

Kapetanopoulos²,

Heller

2003

Curr Cardiol Rep

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Pharmacologic stress testing with myocardial perfusion imaging has enabled patients who cannot complete adequate exercise to undergo diagnostic and prognostic evaluation for coronary artery disease. Pharmacologic stress agents belong to two groups: vasodilators (such as adenosine and dipyridamole), and inotropes (such as dobutamine). All have similar sensitivity (89%-91%) and specificity (78%-86%) for the diagnosis of coronary disease. For risk stratification, the risk of future cardiac events is related to the extent and severity of perfusion abnormalities. Pharmacologic stress testing permits risk stratification as early as 1 to 4 days following an acute myocardial infarction, and is superior to exercise stress testing in this regard. Similarly, it identifies patients at high risk for perioperative cardiac events prior to noncardiac surgery. This review summarizes the current evidence available regarding the diagnostic and prognostic use of pharmacologic stress testing.

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Prognostic value of predischarge dipyridamole technetium 99m sestamibi myocardial tomography in medically treated patients with unstable angina

Cited by 47 publications

References 22 publications

Impact of Diabetes on the Risk Stratification Using Stress Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging in Patients With Symptoms Suggestive of Coronary Artery Disease

Impact of Diabetes on the Risk Stratification Using Stress Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging in Patients With Symptoms Suggestive of Coronary Artery Disease

Estimation of myocardial blood flow and myocardial flow reserve by 99mTc-sestamibi imaging: comparison with the results of [15O]H2O PET

Pharmacologic radionuclide myocardial perfusion imaging

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