Key result
A normal pharmacologic stress 82Rb PET MPI in women with suspected CAD was associated with very low average risks of death (0.72% per year) and nonfatal cardiac events (0.47% per year).
Why the study?
What is the long-term prognosis of a normal pharmacologic stress 82Rb PET MPI study in women with suspected but no prior coronary artery disease?
Cohort (n=457)
What is the long-term prognosis of a normal pharmacologic stress 82Rb PET MPI study in women with suspected but no prior coronary artery disease?
A normal pharmacologic stress 82Rb PET MPI study in women with suspected CAD confers a very low rate of future cardiac events, though those with diabetes or a strong family history of CAD remain at higher risk and require closer surveillance.
Answers are grounded in this paper and cite their sources.
May reassure on prognosis after normal 82Rb PET MPI in women; extends observational data but leaves open need for prospective validation.
OBJECTIVES: Myocardial perfusion imaging (MPI) with positron emission tomography (PET) has advantages over single-photon emission computerized tomography, particularly for women. This investigation was undertaken to define the prognosis of a normal stress PET MPI study in women. METHODS: The cohort comprised 457 women evaluated for suspected coronary artery disease (CAD) who had normal pharmacologic stress (82)Rb PET MPI. No patient had clinically evident CAD. Kaplan-Meier estimates were used to determine death and initial nonfatal cardiac event rates over 7 years. Log rank tests were used to assess the relationship between baseline cardiac risk and events during follow-up, and to contrast survival in the cohort with age- and gender-matched US census comparators. RESULTS: During follow-up, there were 11 deaths (all nonischemic), 3 nonfatal myocardial infarctions, 3 percutaneous coronary interventions and 1 coronary artery bypass operation. Average risks of death and initial nonfatal cardiac events were 0.72 and 0.47% per year, respectively. Cardiac events were associated with a history of diabetes (p < 0.0003) and a family history of CAD (p < 0.05). CONCLUSION: A normal cardiac PET study is associated with a very low rate of future cardiac events. Women with diabetes and a strong family history of CAD are more likely to sustain events and require close surveillance for the development of coronary disease.
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Tosh et al. (2010) conducted a cohort in Suspected coronary artery disease (n=457). Normal pharmacologic stress 82Rb PET MPI vs. Age- and gender-matched US census comparators was evaluated on Death and initial nonfatal cardiac events. A normal pharmacologic stress 82Rb PET MPI in women with suspected CAD was associated with very low average risks of death (0.72% per year) and nonfatal cardiac events (0.47% per year).
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