The prognostic value of cardiac SPECT performed at the primary care physician's office
| Autor: | Fareed M. Collado, Nathan Frogge, Richard G. Trohman, Gautam Balakrishnan, Robert C. Hendel, Maria Octavia Rangel, Rami Doukky, Kathleen Hayes |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Perfusion scanning Perfusion abnormality Revascularization Internal medicine Cause of Death Medicine Humans Radiology Nuclear Medicine and imaging Myocardial infarction Prospective Studies Prospective cohort study Aged Tomography Emission-Computed Single-Photon Primary Health Care business.industry Primary care physician Myocardial Perfusion Imaging Heart Middle Aged medicine.disease Prognosis Coronary revascularization Perfusion Female Radiology Guideline Adherence Cardiology and Cardiovascular Medicine business Mace Follow-Up Studies |
| Zdroj: | Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. 20(4) |
| ISSN: | 1532-6551 |
| Popis: | The prognostic value of single-photon emission computed-tomography (SPECT)-myocardial perfusion imaging (MPI) is well documented. However, the utility of SPECT-MPI when performed at a low-volume primary care physician's (PCP's) office is unknown.We conducted a prospective cohort study of consecutive patients referred by their PCP to undergo a stress-MPI at the PCP's office using a mobile laboratory. Major adverse cardiovascular events (MACE) of death, myocardial infarction (MI), and coronary revascularization were prospectively tabulated using mail and telephone interviews, chart review, and social security death index.One thousand three hundred ninety subjects [mean age 58 ± 13 years; 44% women] were followed for 27 ± 9 months, with a 99% complete follow-up rate. Subjects with abnormal MPI [174 (12.5%)] had significantly higher rates of all-cause mortality [5.2% vs 1.0%, P.001], death, or MI [5.7% vs 1.5%, P = .001], and the composite of death, MI, or late revascularization (60 days post-MPI) [12.6 vs 2.7%, P.001]. Overall MACE risk was associated with the total perfusion abnormality burden, while the revascularization rate was related to the reversible perfusion abnormality burden.Contemporary SPECT-MPI performed in the setting of a PCP's office carries a robust prognostic value, similar to that reported in tertiary or large-volume practice settings. |
| Databáze: | OpenAIRE |
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