دورية أكاديمية
أعرض في EDS

Risk stratification in patients with remote prior myocardial infarction using rest-stress myocardial perfusion SPECT: prognostic value and impact on referral to early catheterization.

التفاصيل البيبلوغرافية
العنوان: Risk stratification in patients with remote prior myocardial infarction using rest-stress myocardial perfusion SPECT: prognostic value and impact on referral to early catheterization.
المؤلفون: Zellweger MJ; Department of Imaging (Division of Nuclear Medicine), Cedars-Sinai Medical Center, The CSMC Burns and Allen Research Institute, Los Angeles, Calif. 90048, USA., Dubois EA, Lai S, Shaw LJ, Amanullah AM, Lewin HC, Friedman JD, Kang X, Germano G, Berman DS
المصدر: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2002 Jan-Feb; Vol. 9 (1), pp. 23-32.
نوع المنشور: Evaluation Study; Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: United States NLM ID: 9423534 Publication Model: Print Cited Medium: Print ISSN: 1071-3581 (Print) Linking ISSN: 10713581 NLM ISO Abbreviation: J Nucl Cardiol Subsets: MEDLINE
أسماء مطبوعة: Publication: New York : Springer
Original Publication: St. Louis, MO : Mosby-Year Book, Inc., c1994-
مواضيع طبية MeSH: Myocardial Infarction/*diagnostic imaging , Myocardial Ischemia/*diagnostic imaging , Tomography, Emission-Computed, Single-Photon/*methods, Adenosine ; Aged ; Aged, 80 and over ; Exercise Test ; Female ; Follow-Up Studies ; Health Care Costs ; Heart/diagnostic imaging ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction/complications ; Myocardial Ischemia/etiology ; Outcome Assessment, Health Care ; Prognosis ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed, Single-Photon/economics
مستخلص: Background: Little is known about the prognostic value of myocardial perfusion single photon emission computed tomography (SPECT) in patients with remote prior myocardial infarction (MI).
Methods and Results: We identified 1413 consecutive patients with remote prior MI who underwent rest-stress myocardial perfusion SPECT. Semiquantitative visual analysis of 20 SPECT segments was used to define the summed stress, rest, and difference scores. The number of non-reversible segments was used as an index of infarct size. During follow-up (>or=1 year), 118 hard events occurred: 64 cardiac deaths (CDs) and 54 recurrent MIs. Annual CD and hard event rates increased significantly as a function of SPECT abnormality. For summed stress scores less than 4, 4 to 8, 9 to 13, and more than 13, the annual CD rates were 0.4%, 0.9%, 1.7%, and 3.5%, respectively (P =.002). Patients with small MI (<4 non-reversible segments) and no or mild ischemia (summed difference score or=4 non-reversible segments) had moderate to high annual CD rates (3.7%-6.6%) regardless of the extent of ischemia. Nuclear testing added incremental prognostic information to pre-scan information. Compared with a strategy in which all patients are referred to catheterization, a strategy that referred only those patients with a risk for CD of greater than 1% by myocardial perfusion SPECT resulted in a 41.6% cost savings.
Conclusions: Myocardial perfusion SPECT adds incremental value to pre-scan information and is highly predictive and cost-efficient in the risk stratification of patients with remote prior MI. Patients with normal or mildly abnormal scan results or small MI in combination with absent or mild ischemia have a low risk for CD.
التعليقات: Comment in: J Nucl Cardiol. 2002 Jan-Feb;9(1):124-6. (PMID: 11845137)
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المشرفين على المادة: 971Z4W1S09 (Technetium Tc 99m Sestamibi)
K72T3FS567 (Adenosine)
تواريخ الأحداث: Date Created: 20020215 Date Completed: 20020327 Latest Revision: 20240130
رمز التحديث: 20240130
DOI: 10.1067/mnc.2002.118925
PMID: 11845126
قاعدة البيانات: MEDLINE
الوصف
تدمد:1071-3581
DOI:10.1067/mnc.2002.118925