Prognostic value of stress myocardial perfusion positron emission tomography: results from a multicenter observational registry.
J Am Coll Cardiol
; 61(2): 176-84, 2013 Jan 15.
Article
en En
| MEDLINE
| ID: mdl-23219297
ABSTRACT
OBJECTIVES:
The primary objective of this multicenter registry was to study the prognostic value of positron emission tomography (PET) myocardial perfusion imaging (MPI) and the improved classification of risk in a large cohort of patients with suspected or known coronary artery disease (CAD).BACKGROUND:
Limited prognostic data are available for MPI with PET.METHODS:
A total of 7,061 patients from 4 centers underwent a clinically indicated rest/stress rubidium-82 PET MPI, with a median follow-up of 2.2 years. The primary outcome of this study was cardiac death (n = 169), and the secondary outcome was all-cause death (n = 570). Net reclassification improvement (NRI) and integrated discrimination analyses were performed.RESULTS:
Risk-adjusted hazard of cardiac death increased with each 10% myocardium abnormal with mildly, moderately, or severely abnormal stress PET (hazard ratio [HR] 2.3 [95% CI 1.4 to 3.8; p = 0.001], HR 4.2 [95% CI 2.3 to 7.5; p < 0.001], and HR 4.9 [95% CI 2.5 to 9.6; p < 0.0001], respectively [normal MPI referent]). Addition of percent myocardium ischemic and percent myocardium scarred to clinical information (age, female sex, body mass index, history of hypertension, diabetes, dyslipidemia, smoking, angina, beta-blocker use, prior revascularization, and resting heart rate) improved the model performance (C-statistic 0.805 [95% CI 0.772 to 0.838] to 0.839 [95% CI 0.809 to 0.869]) and risk reclassification for cardiac death (NRI 0.116 [95% CI 0.021 to 0.210]), with smaller improvements in risk assessment for all-cause death.CONCLUSIONS:
In patients with known or suspected CAD, the extent and severity of ischemia and scar on PET MPI provided powerful and incremental risk estimates of cardiac death and all-cause death compared with traditional coronary risk factors.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
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Tomografía de Emisión de Positrones
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Imagen de Perfusión Miocárdica
Tipo de estudio:
Clinical_trials
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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 Am Coll Cardiol
Año:
2013
Tipo del documento:
Article
País de afiliación:
Estados Unidos