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Meeting ReportCardiovascular

Prognostic value of simultaneous myocardial perfusion imaging (MPI) and coronary calcium score (CCS) assessment in patients with intermediate likelihood of CAD: A 5-year follow-up study

Corrado Cittanti, Emanuela Succi Leonelli, Donato Mele, Valentina de Cristofaro, Chiara Peterle, Stefano Panareo, Ivan Santi and Luciano Feggi
Journal of Nuclear Medicine May 2013, 54 (supplement 2) 1688;
Corrado Cittanti
1Nuclear Medicine, University Hospital, Ferrara, Italy
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Emanuela Succi Leonelli
2Cardiology Unit, Delta's Hospital, Lagosanto, Italy
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Donato Mele
3Cardiology Unit, University Hospital, Ferrara, Italy
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Valentina de Cristofaro
1Nuclear Medicine, University Hospital, Ferrara, Italy
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Chiara Peterle
1Nuclear Medicine, University Hospital, Ferrara, Italy
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Stefano Panareo
1Nuclear Medicine, University Hospital, Ferrara, Italy
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Ivan Santi
1Nuclear Medicine, University Hospital, Ferrara, Italy
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Luciano Feggi
1Nuclear Medicine, University Hospital, Ferrara, Italy
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Abstract

1688

Objectives SPECT-CT allows the simultaneous evaluation of functional (MPI) and morphoanatomical (CCS) aspects of the atherosclerosis. This study aims to assess the additional prognostic value of CCS in patients with intermediate-risk of CAD, undergoing MPI.

Methods we evaluated 351 patients (232 men, 68±13 years) presenting with an intermediate Framingham risk of CAD. All subjects underwent contextual rest MPI and CCS evaluation as a part of a standard two-days MPI protocol, acquiring images with an hybrid Siemens Symbia tomograph. Summed Stress Scores (SSS) and Agatston data were calculated for all patients and MPI studies were considered “positive” (+) if SSS>3.

Results the study population was followed for 63±10 months considering cardiac death, non-fatal MI, hospitalization for unstable angina and late (>90 days) coronary revascularization as outcome events. Subjects were divided into four groups on the basis of tests results: MPI- and CCS<400 (group A - 134), MPI- and CCS≥400 (group B - 62), MPI+ and CCS<400 (group C - 34), and MPI+ and CCS≥400 (group D - 121). The global cardiac event rate was 2.7%/year. Annual event rates for overall cardiac events in group A, B, C and D were 0.3, 1.4, 4.4 and 5.7%/year respectively. Patients with normal MPI had higher survival free of cardiac events (p<0.01) and an increase in predicting all cardiac events occurred when CCS data were added to MPI information. Kaplan-Meier curves showed significant differences in event-free survival at 5 years in the four groups.

Conclusions this study outlines that an hybrid approach, combining anatomic assessment of coronary plaque burden (better estimating longer-term prognosis) with functional evaluation of ischemia (more closely related to a “short-term risk”) may contribute to refine temporal risk stratification among subjects at intermediate likelihood of CAD.

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Journal of Nuclear Medicine
Vol. 54, Issue supplement 2
May 2013
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Prognostic value of simultaneous myocardial perfusion imaging (MPI) and coronary calcium score (CCS) assessment in patients with intermediate likelihood of CAD: A 5-year follow-up study
Corrado Cittanti, Emanuela Succi Leonelli, Donato Mele, Valentina de Cristofaro, Chiara Peterle, Stefano Panareo, Ivan Santi, Luciano Feggi
Journal of Nuclear Medicine May 2013, 54 (supplement 2) 1688;

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Prognostic value of simultaneous myocardial perfusion imaging (MPI) and coronary calcium score (CCS) assessment in patients with intermediate likelihood of CAD: A 5-year follow-up study
Corrado Cittanti, Emanuela Succi Leonelli, Donato Mele, Valentina de Cristofaro, Chiara Peterle, Stefano Panareo, Ivan Santi, Luciano Feggi
Journal of Nuclear Medicine May 2013, 54 (supplement 2) 1688;
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