Key result
Rubidium-82 PET stress testing in low-risk ED chest pain patients yielded an abnormal scan in 4.6% of patients, demonstrating feasibility for predicting acute coronary syndrome.
Why the study?
Does Rubidium-82 PET stress testing accurately predict acute coronary syndrome in low-risk emergency department chest pain patients?
Cross-Sectional (n=1,177)
Does Rubidium-82 PET stress testing accurately predict acute coronary syndrome in low-risk emergency department chest pain patients?
Rubidium-82 PET stress testing is a feasible alternative to traditional provocative testing for evaluating low-risk chest pain patients in an emergency department observation unit.
Answers are grounded in this paper and cite their sources.
Supports feasibility of Rb-82 PET in low-risk ED chest pain; hypothesis-generating for ACS prediction and requires prospective validation.
OBJECTIVE: To evaluate the feasibility of dipyridamole-induced reversible ischemia on myocardial perfusion positron emission tomography (PET) imaging using Rubidium-82 (Rb-82 PET) to predict the presence of acute coronary syndrome (ACS) in emergency department (ED) chest pain patients at low risk who were admitted to an observation unit. METHODS: Retrospective cross-sectional study of electronic medical records after computerized record retrieval. We matched all ED chest pain visits to a database of all scans read by cardiology between January 1, 2004 and January 1, 2006. A PET scan was performed at the ED physician's discretion after a negative observation unit workup, including serial cardiac biomarkers and ECGs. Data were collected on a standardized abstraction instrument. RESULTS: There were 7,691 ED visits for chest pain. Among these patients, 1177 had an Rb-82 PET. Fifty four (4.6%) of these patients had an abnormal or probably abnormal scan. Of these, 28 had catheter-proven significant coronary disease, requiring either revascularization or intensive medical management; 22 patients had ACS by clinical assessment but did not undergo catheterization. Four had no coronary artery disease on catheterization. CONCLUSION: In a low-risk chest pain population, cardiac PET imaging had true-positive cardiac catheterization rates which were comparable to prior studies of SPECT sestimibi imaging and coronary CTA imaging. With the rapid dissemination of PET technology, and superior performance compared to current imaging methods, myocardial perfusion PET is a feasible alternative to traditional provocative testing in an ED observation unit.
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Osborne et al. (2011) conducted a cross-sectional in Low-risk chest pain (n=1,177). Rubidium-82 Positron Emission Tomography (Rb-82 PET) stress testing was evaluated on Abnormal or probably abnormal scan. Rubidium-82 PET stress testing in low-risk ED chest pain patients yielded an abnormal scan in 4.6% of patients, demonstrating feasibility for predicting acute coronary syndrome.
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