Prognostic value of myocardial perfusion SPECT images in combination with the maximal heart rate at exercise testing in Japanese patients with suspected ischemic heart disease: a sub-analysis of J-ACCESS
| Autor: | Takuya Yamazaki, Osamu Nishiyama, Satoru Usami, Kazuwa Nakao, Shinji Yasuno, Akira Yamashina, Tsunehiko Nishimura, Kenji Ueshima |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Gated SPECT Myocardial Ischemia Coronary artery disease Myocardial perfusion imaging Japan Heart Rate Stress Physiological Internal medicine Heart rate medicine Humans Multicenter Studies as Topic Radiology Nuclear Medicine and imaging Myocardial infarction Aged Tomography Emission-Computed Single-Photon Cardiac events medicine.diagnostic_test business.industry Hazard ratio Myocardial Perfusion Imaging General Medicine J-ACCESS Middle Aged Prognosis medicine.disease SSS SPECT Data Interpretation Statistical Heart failure Exercise Test Cardiology Female business |
| Zdroj: | Annals of Nuclear Medicine. 23:849-854 |
| ISSN: | 1864-6433 0914-7187 |
| Popis: | Objectives We assessed whether a combination of summed stress scores (SSS) using exercise myocardial perfusion SPECT (Ex-SPECT) and maximal heart rate accurately predicts cardiac events through a sub-analysis of J-ACCESS (Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT) which was conducted to evaluate the prognosis of Japanese patients with suspected ischemic heart disease. Methods In J-ACCESS, 2, 373 patients with suspected coronary artery disease not receiving beta-blocker treatment underwent Ex-SPECT. These patients were categorized into the following four groups: Group A [achieved target heart rate (THR) and SSS < 4: n = 631], B (did not achieve THR and SSS < 4: n = 612), C (achieved THR and SSS ≥ 4: n = 570), and D (did not achieve THR and SSS ≥ 4: n = 560). We evaluated the incidence rate of cardiac events including cardiac death, myocardial infarction, and heart failure requiring hospital admission during a 3-year period. Results In Group A, B, C, and D, 9 of 631 (1.4%), 15 of 612 (2.4%), 23 of 570 (4.0%) and 30 of 560 (5.4%) patients experienced cardiac events, respectively. Although the hazard ratio of the SSS ≥ 4 was 2.45 (p < 0.001) and that of the attained THR was 0.69 (p = 0.10) in the multiple Cox regression analysis, Kaplan–Meier curves showed that the cardiac events rate was lower in the order of A, B, C, and D (p < 0.001). Conclusion The combination of SSS using Ex-SPECT and the maximal heart rate is a useful predictor of cardiac events in patients with suspected coronary artery disease. |
| Databáze: | OpenAIRE |
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