TY - JOUR T1 - Prognostic Value of Myocardial Perfusion Imaging with a Cadmium-Zinc-Telluride SPECT Camera in Patients Suspected of Having Coronary Artery Disease JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1459 LP - 1463 DO - 10.2967/jnumed.116.188516 VL - 58 IS - 9 AU - Elsemiek M. Engbers AU - Jorik R. Timmer AU - Mohamed Mouden AU - Siert Knollema AU - Pieter L. Jager AU - Jan Paul Ottervanger Y1 - 2017/09/01 UR - http://jnm.snmjournals.org/content/58/9/1459.abstract N2 - 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. ER -