Key result
Preoperative SPECT yields low positive predictive value of ~4% for postoperative cardiac events.
Why the study?
Does preoperative myocardial perfusion SPECT accurately predict postoperative cardiac events in adult patients undergoing noncardiac surgery?
Observational (n=131)
No
Does preoperative myocardial perfusion SPECT accurately predict postoperative cardiac events in adult patients undergoing noncardiac surgery?
Absolute Event Rate: 4% vs 0%
Preoperative myocardial perfusion SPECT has a very low positive predictive value for postoperative cardiac events in noncardiac surgery, suggesting it is often overutilized and should be restricted to appropriate use criteria.
Low PPV of preoperative SPECT cautions against routine use in noncardiac surgery; leaves open targeted application in selected high-risk patients.
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Al-Oweidi et al. (2017) conducted an observational in Patients undergoing noncardiac surgery (n=131). Abnormal preoperative myocardial perfusion SPECT vs. Normal preoperative myocardial perfusion SPECT was evaluated on Postoperative cardiac events (cardiac death, nonfatal myocardial infarction, and unstable angina). Preoperative myocardial perfusion SPECT identified myocardial ischemia in 18% of patients but had a low positive predictive value of 4% for postoperative cardiac events.
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