Outcome of patients with high-risk Duke treadmill score and normal myocardial perfusion imaging on spect
| Autor: | Arnaldo Lafitte Stier Jr., Olímpio Ribeiro França Neto, Otávio J. Kormann, Rodrigo Cerci, Isabella Shin-Ike, João V. Vitola, Mauro R. B. Wanderley, Claudio Da Cunha, Carlos Cunha Pereira Neto, José Antônio da Silva |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Comorbidity Coronary Artery Disease Duke treadmill score 030204 cardiovascular system & hematology Sensitivity and Specificity 030218 nuclear medicine & medical imaging Ventricular Dysfunction Left 03 medical and health sciences Myocardial perfusion imaging 0302 clinical medicine Risk Factors Prevalence Humans Medicine Radiology Nuclear Medicine and imaging Myocardial infarction Survival analysis Aged Cardiovascular mortality Tomography Emission-Computed Single-Photon Ejection fraction medicine.diagnostic_test business.industry Mortality rate Myocardial Perfusion Imaging Reproducibility of Results Stroke Volume Middle Aged Prognosis medicine.disease Causality Survival Rate Death Sudden Cardiac Female Cardiology and Cardiovascular Medicine business Nuclear medicine Perfusion Brazil |
| Zdroj: | Journal of Nuclear Cardiology. 23:1291-1300 |
| ISSN: | 1532-6551 1071-3581 |
| DOI: | 10.1007/s12350-015-0156-x |
| Popis: | Annual mortality rate can range from1% for patients with normal myocardial perfusion by SPECT to5% based on a high-risk Duke treadmill score (DTS). Information on the prognosis of patients with the combination of HRDTS and normal SPECT is limited and is the purpose of this study.Data from a large nuclear cardiology registry (n = 17,972 patients) were reviewed. A total of 340 had HRDTS (score ≤ -11) while undergoing SPECT. Combined cardiovascular mortality and non-fatal myocardial infarction (MI) and cardiovascular mortality alone were available in 310 patients at a mean follow-up of 4.01 ± 1.5 years.The majority of the patients had abnormal SPECT (n = 270, 71%). The abnormal SPECT patients compared to the normal were older (65.6 vs 62.8 years of age; P = .025), more likely to have abnormal left ventricular ejection fraction (26.1% vs 0%; P .0001), known coronary artery disease (CAD, 35.9% vs 7.8%; P .0001) and lower DTS (-14.5 vs -13.2; P = .0006), Kaplan-Meier survival analysis demonstrated a significantly lower cardiovascular mortality (5.4% vs 0%, P = .02) and combined outcome of MI and cardiovascular mortality (15% vs 4.4%, P = .009) in patients with normal versus abnormal SPECT.High-risk DTS is associated with abnormal perfusion SPECT in most patients, but nearly one-third of the patients had normal perfusion. Patients with a normal SPECT had a lower cardiovascular event rates. |
| Databáze: | OpenAIRE |
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