Key result
The choice between 99mTc-tetrofosmin and 99mTc-sestamibi did not significantly affect the prediction of all-cause (P=0.62) or cardiovascular mortality (P=0.96) in patients with CAD.
Why the study?
Does the choice of imaging agent (99mTc-sestamibi vs 99mTc-tetrofosmin) affect the prediction of mortality in patients with coronary artery disease undergoing vasodilator stress testing?
Cohort (n=2,147)
Does the choice of imaging agent (99mTc-sestamibi vs 99mTc-tetrofosmin) affect the prediction of mortality in patients with coronary artery disease undergoing vasodilator stress testing?
p-value: P=0.62 for all-cause death, P=0.96 for cardiovascular death
The choice between 99mTc-sestamibi and 99mTc-tetrofosmin for myocardial perfusion imaging does not affect prognostic assessment for mortality in patients with coronary artery disease.
PURPOSE: To compare the prognostic ability of the imaging agents 99mTc-sestamibi versus 99mTc-tetrofosmin to predict mortality outcomes in patients with documented coronary artery disease and undergoing vasodilator stress testing. MATERIALS AND METHODS: The study included 2147 consecutive patients who underwent rest and stress single photon emission computed tomographic (SPECT) examination with either 99mTc-sestamibi (n=1128) or 99mTc-tetrofosmin (n=1019). Information relating to all-cause death and cardiovascular death was collected over a 4-year study period. Unadjusted Kaplan-Meier estimates were compared for the two imaging agents. Cox proportional hazard models were examined to determine the incremental contribution of SPECT sum stress score (SSS) and the imaging agent after adjusting for clinical and demographic characteristics. Additionally, the interaction between SSS and agent was examined to determine if the effect of SSS on prognosis was different for the two agents. RESULTS: Vasodilator agents were used for stress testing in all patients who received 99mTc-tetrofosmin and 99mTc-sestamibi. Despite differences in patient risk factors Kaplan-Meier estimates were similar for the two groups of patients. Resulting P-values for differences between models for the end points of (1) death from any cause and (2) cardiovascular death showed that SSS combined with clinical index was significantly better than a model that adjusted for only baseline characteristics (P<0.0001 for both endpoints). The addition of imaging agent (99mTc-tetrofosmin or 99mTc-sestamibi) to the model containing both SSS and the clinical characteristics did not show further significant improvement (P=0.62, P=0.96 for death from any cause and cardiovascular death, respectively). CONCLUSION: The type of clinically available 99mTc-labelled myocardial perfusion agents did not affect interpretation of results for prognostic assessment.
No takes yet. Share an insight, caveat, or question.
Adams et al. (2007) conducted a cohort in Coronary artery disease (n=2,147). 99mTc-tetrofosmin vs. 99mTc-sestamibi was evaluated on All-cause death and cardiovascular death (p=P=0.62 for all-cause death, P=0.96 for cardiovascular death). The choice between 99mTc-tetrofosmin and 99mTc-sestamibi did not significantly affect the prediction of all-cause (P=0.62) or cardiovascular mortality (P=0.96) in patients with CAD.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: