Prediction of 8-year cardiovascular outcomes in patients with systemic arterial hypertension: value of stress (99m)Tc-tetrofosmin myocardial perfusion imaging in a high-risk cohort.
J Nucl Cardiol
; 20(6): 1030-40, 2013 Dec.
Article
en En
| MEDLINE
| ID: mdl-24132813
ABSTRACT
OBJECTIVE:
Systemic arterial hypertension is a strong and prevalent cardiovascular risk factor. Currently, information on the very long-term prognostic value of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients with systemic arterial hypertension is lacking. The aim of this study was to assess the value of stress (99m)Tc-tetrofosmin MPI for the prediction of very long-term outcome in these patients.METHODS:
The study population consisted of 608 patients with systemic arterial hypertension who underwent exercise or dobutamine stress (99m)Tc-tetrofosmin MPI for the assessment of known or suspected coronary artery disease. Follow-up was successful in 600 (99%) patients. The endpoints were all-cause mortality, cardiac death, nonfatal infarction, and coronary revascularization. Kaplan-Meier survival cures were constructed and univariate and multivariate analyses were performed to identify predictors of very long-term outcome.RESULTS:
The mean age of the patients was 59 ± 10 years, and 65% of them were male. MPI findings were normal in 301 patients (50%). Myocardial perfusion abnormalities were fixed in 162 (27%) and reversible in 137 (23%) patients. During a median 8.1-year follow-up, 241 (40%) patients died (121 cardiac deaths), 52 (9%) had a nonfatal myocardial infarction, and 128 (21%) underwent coronary revascularization. Survival curves in patients with a low vs a high summed difference score diverged up to 5 years after the test was performed. Multivariate analyses demonstrated that SPECT MPI provided incremental prognostic information up to 5 years after the test.CONCLUSIONS:
Stress (99m)Tc-tetrofosmin MPI provides incremental prognostic information for the prediction of cardiovascular outcome in patients with systemic arterial hypertension. Patients with normal stress MPI have a significantly better prognosis as compared with those with an abnormal study, up to 5 years after the test is performed.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Compuestos Organofosforados
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Compuestos de Organotecnecio
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Tomografía Computarizada de Emisión de Fotón Único
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Imagen de Perfusión Miocárdica
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Hipertensión
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Nucl Cardiol
Asunto de la revista:
CARDIOLOGIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Países Bajos