Article Figures & Data
Figures
- FIGURE 1.
Patients screened and excluded from study entry.
- FIGURE 2.
Timeline in hours from admission to hospital discharge in randomized groups. There were no significant differences from randomization to diagnosis or hospital discharge in patients who underwent SO SPECT versus a normal CTA.
- FIGURE 3.
Time to diagnosis and hospital discharge in randomized groups. Cumulative frequency from randomization to final diagnosis (A) and hospital discharge (B) for CTA, overall SPECT, and SO groups. Horizontal line is at 50th percentile.
- FIGURE 4.
Cardiac events based on SPECT and CTA results survival curves show comparably low cardiac event rates in patients with normal SPECT and CTA and low rates of ICA and CR.
Tables
Characteristic Total (n = 598) SPECT (n = 310) CTA (n = 288) P Mean age ± SD 53.2 ± 12.2 52.6 ± 11.9 53.9 ± 12.5 0.18 Female sex 332 (56.1) 174 (56.1) 158 (54.9) 0.76 Race 0.05 Black 178 (29.8) 101 (32.6) 77 (26.7) White 334 (55.9) 172 (55.5) 162 (56.3) Hispanic 69 (11.5) 30 (9.6) 39 (13.5) Asian 8 (1.3) 1 (0.3) 7 (2.4) Other 9 (1.5) 6 (1.9) 3 (1.1) Body mass index 31.2 ± 8.3 31.8 ± 9.1 30.5 ± 7.4 0.05 Risk factors 5 (1,10) 4 (2,10) 0.60 Hypertension 301 (50.3) 157 (50.7) 144 (50.0) 0.88 Diabetes mellitus 90 (15.1) 48 (15.4) 42 (14.6) 0.76 Dyslipidemia 228 (38.1) 115 (37.1) 113 (39.2) 0.59 Current smoker 162 (27.1) 85 (27.2) 77 (26.4) 0.98 Family history of CAD 137 (22.9) 66 (21.3) 71 (24.7) 0.33 Acetylsalicylic acid within past 7 d 184 (30.8) 97 (31.3) 87 (30.2) 0.78 Severe angina last 24 h 32 (5.4) 14 (4.5) 18 (6.3) 0.35 Thrombolysis in Myocardial Infarction risk score 0.67 0 315 (52.7) 170 (54.8) 145 (50.4) 1 183 (30.6) 90 (29.0) 93 (32.3) 2 86 (14.4) 44 (14.2) 42 (14.6) 3 14 (2.3) 6 (1.9) 8 (2.8) Framingham risk score 0.95 0%–10% (low) 458 (76.6) 239 (77.1) 219 (76.0) 11%–20% (intermediate) 113 (18.9) 57 (18.4) 56 (19.4) >20% (high) 27 (4.5) 14 (4.5) 13 (4.5) Data are mean ± SD for continuous variables; medians, with interquartile ranges in parentheses if continuous variables were skewed; and numbers, with percentages in parentheses for categoric variables.
Protocol n Radiotracer dose (MBq) Radiation exposure (mSv) SPECT Rest–stress 124 (40.4) 1,698 ± 148 11.7 ± 1.0 Stress–rest 74 (24.1) 1,480 ± 507 12.5 ± 3.0 2-day 35 (11.4) 2,253 ± 570 15.5 ± 3.9 Stress-only 74 (24.1) 644 ± 374 5.5 ± 4.4 Stress–rest or rest–stress 233 (75.9) 1,713 ± 448* 12.5 ± 2.7* Overall, 49 of 307 (16%) patients received <5 mSv 1,454 ± 629 10.9 ± 4.4 CTA Retrospective 126 (44.7) 16.4 ± 3.3 Retrospective with dose modulation 102 (36.2) 12.0 ± 2.4 Prospective 54 (19.1) 5.2 ± 0.6 Overall, 20 of 282 (7.1%) patients received <5 mSv 12.7 ± 4.9 ↵* P < 0.0001 stress-only vs. stress–rest.
Data in parentheses are percentages.
Supplemental Data
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