RT Journal Article
SR Electronic
T1 Prognostic value of quantitative high-speed myocardial perfusion imaging in multi-center study
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 505
OP 505
VO 59
IS supplement 1
A1 Otaki, Yuka
A1 Betancur, Julian
A1 Sharir, Tali
A1 Hu, Lien-Hsin
A1 Nejatbakhsh Azadani, Peyman
A1 Fish, Mathews
A1 Ruddy, Terrence
A1 Dorbala, Sharmila
A1 Germano, Guido
A1 Tamarappoo, Balaji
A1 Dey, Damini
A1 Berman, Daniel
A1 Slomka, Piotr
YR 2018
UL http://jnm.snmjournals.org/content/59/supplement_1/505.abstract
AB 505Background: Although prior studies have examined prognostic performance of high-speed SPECT myocardial perfusion imaging (HS-MPI) using cadmium zinc telluride detectors, it has been limited to single centers and small cohorts. We studied the predictive value of fully automated myocardial perfusion analysis from a large cohort from 4 different centers. Methods: We studied 15367 patients (64±12 years, 56% male) undergoing exercise or pharmacologic stress 99mTc-sestamibi HS-MPI and followed for 3.2 ± 1.6 years for adverse major cardiac event (MACE). Automated quantitative software was used to compute stress total perfusion deficit (sTPD). MPI was classified as sTPD=0%, 0<sTPD<1, 1≤sTPD<3, 3≤sTPD<5 5≤sTPD<10, 10≤sTPD<20 and 20≤sTPD. MACE consisted of all-cause mortality, nonfatal myocardial infarction, unstable angina, or late coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting). Kaplan Meier and Cox proportional hazards analysis were performed to test the performance of sTPD to predict MACE. Annualized MACE rate was compared between male and female. RESULTS: During follow-up, 1461 MACE occurred (9.5%). Annualized MACE rate increased with progressively increasing sTPD; sTPD=0% (1.1%), 0<sTPD<1 (1.7%),1≤sTPD<3 (2.3%), 3≤sTPD<5 (2.9%), 5≤sTPD<10 (4.5%), 10≤sTPD<20 (7.1%), and 20≤sTPD (9.6%) (log-rank P<0.0001, Figure). Similarly, the annualized MACE rate in male and female increased with progressively increasing sTPD; sTPD=0% (0.9% in female vs 1.6% male, P=0.15), 0<sTPD<1 (1.4% in female vs 2.0% male, P=0.05), 1≤sTPD<3 (2.0% in female vs 2.5% male, P=0.03), 3≤sTPD<5 (2.5% in female vs 3.2% male, P= 0.04), 5≤sTPD<10 (4.1% in female vs 4.7% male, P=0.08), 10≤sTPD<20 (6.6% in female vs 7.3% male, P=0.18), and 20≤sTPD (13.2% in female vs 8.9% male, P=0.04), (log-rank P for both<0.0001, Figure). CONCLUSIONS: By quantitative analysis, MACE increases progressively with increasing perfusion abnormality among patients undergoing stress HS-MPI in all, male and female. Differences in MACE rate exist between female and male populations with the same quantitative MPS results.