Journal
CIRCULATION JOURNAL
Volume 71, Issue 10, Pages 1580-1585Publisher
JAPANESE CIRCULATION SOC
DOI: 10.1253/circj.71.1580
Keywords
acute coronary syndrome; cardiac death; coronary artery disease; single-photon emission; computed tomography
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Background The prognostic value of rest Tl-201/stress Tc-99m-tetrofosmin myocardial perfusion single-photon emission computed tomography (SPECT) for the prediction of future hard cardiac events, including acute myocardial infarction (AMI), unstable angina (UAP) and cardiac death, and the implications for risk stratification has not yet been defined in a Japanese population. Methods and Results The 1,988 patients who underwent rest (TI)-T-201/stress Tc-99m-tetrofosmin SPECT were identified and followed up for the occurrence of AMI, UAP and cardiac death. The mean follow-up interval was 26.9 +/- 15.8 months. The 142 patients were revascularized within 60 days after SPECT and they were censored from the prognostic analysis. Summed stress score (SSS), summed rest score and summed difference score (SDS) were calculated using a 5-point scoring (Normal: 0, No uptake: 4) and a 20-segment model; 22 cases of myocardial infarction, 31 of UAP and 22 cardiac deaths occurred (1.2%, 1.7% and 1.2%, respectively). Multivariate Cox regression analysis showed that hypertension (Wald 6.37, p < 0.05) and SDS (Wald 8.77, p < 0.01) were independent predictors of AMI and UAP. Advanced age (Wald 16.0, p < 0.001), SSS (Wald 10.9, p < 0.01) and SDS (Wald 4.58, p < 0.05) were independent predictors of cardiac death. Conclusion Myocardial perfusion SPECT yields prognostic information toward the identification of acute coronary syndrome and cardiac death.
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