PT  - JOURNAL ARTICLE
AU  - Elsemiek M. Engbers
AU  - Jorik R. Timmer
AU  - Mohamed Mouden
AU  - Siert Knollema
AU  - Pieter L. Jager
AU  - Jan Paul Ottervanger
TI  - Prognostic Value of Myocardial Perfusion Imaging with a Cadmium-Zinc-Telluride SPECT Camera in Patients Suspected of Having Coronary Artery Disease
AID  - 10.2967/jnumed.116.188516
DP  - 2017 Sep 01
TA  - Journal of Nuclear Medicine
PG  - 1459--1463
VI  - 58
IP  - 9
4099  - http://jnm.snmjournals.org/content/58/9/1459.short
4100  - http://jnm.snmjournals.org/content/58/9/1459.full
SO  - J Nucl Med2017 Sep 01; 58
AB  - The prognostic value of myocardial perfusion imaging (MPI) with the cadmium-zinc-telluride (CZT) SPECT camera is not well established. Therefore, the aim of the current study was to evaluate the prognostic value of MPI performed with a CZT SPECT camera in a large cohort of patients suspected of having coronary artery disease. Methods: Consecutive symptomatic stable patients (n = 4,057) without a history of coronary artery disease underwent CZT SPECT MPI. During a median follow-up of 2.4 y (25th–75th percentile, 1.7–3.4), patients were monitored for primary (nonfatal myocardial infarction and cardiac mortality) and secondary outcomes (late revascularization [>90 d after scanning] and primary outcome). Results: Patients with normal perfusion demonstrated low annual event rates (primary outcome, 0.2%; secondary outcome, 0.6%). Annual event rates increased with the extent of abnormality of myocardial perfusion. In patients with small ischemic perfusion defects, annual event rates were 0.7% and 2.8% for the primary and secondary outcome, respectively. In patients with moderate or large ischemic perfusion defects, these event rates were 1.2% and 4.3%, respectively. After multivariate analysis, the risk for events was significantly associated with the extent of ischemia (hazard ratio for small ischemic defects: 2.2, 95% confidence interval [CI], 0.9–5.9 and 4.6, 95% CI, 2.8–7.6, for primary and secondary outcomes, respectively; hazard ratio for moderate or large ischemic defects: 4.0, 95% CI, 1.5–10.5 and 12.1, 95% CI, 7.2–20.2, for primary and secondary outcomes, respectively). Conclusion: Our findings show that MPI acquired with a CZT SPECT camera provides excellent prognostic information, with low event rates in patients with normal myocardial perfusion. In patients with abnormal SPECT MPI, the extent of abnormality is independently associated with an increased risk of events.