Key result
Normal stress 99mTc-Sestamibi SPECT is linked to a ~0.3% annual hard cardiac event rate.
Why the study?
The clinical outcome of patients with normal stress technetium-99m Sestamibi SPECT myocardial perfusion imaging with different probabilities of coronary artery disease was not well established.
What is the one-year prognosis of patients with suspected coronary artery disease and a normal stress technetium-99m (99mTc)-Sestamibi SPECT myocardial perfusion imaging?
Cohort (n=1,047)
No
What is the one-year prognosis of patients with suspected coronary artery disease and a normal stress technetium-99m (99mTc)-Sestamibi SPECT myocardial perfusion imaging?
Patients with suspected coronary artery disease and a normal 99mTc-Sestamibi myocardial SPECT have a very low incidence of cardiovascular events at one year.
Normal MPI tied to low event rates varying by pretest CAD likelihood; leaves open refined prognostic models in larger cohorts.
INTRODUCTION: The aim of the present study was to evaluate the clinical outcome of a normal stress technetium-99m (99mTc)-Sestamibi single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) with different probabilities of coronary artery disease (CAD). MATERIAL AND METHODS: A total of 1,047 subjects with a normal 99mTc-MIBI SPECT were followed up for one year and hard and soft cardiac events were assessed. Hard cardiac events were defined as cardiac death or non-fatal myocardial infarction (MI). Soft cardiac events included the patient's development of recurrent chest pain requiring coronary revascularization or significant stenosis in coronary arteries on angiography. RESULTS: Overall, 1,047 patients (248 men and 799 women; mean age: 60.07 ± 12.31, range 29-92) were enrolled. Three hard cardiac events occurred in the groups; two had cardiac arrest and one non-fatal MI. As a result, the annualized hard cardiac event rate was 0.28%, the annualized cardiac mortality rate was 0.19%, and the rate of overall annualized cardiac events was 1.25%. Furthermore, there was a significant difference in cardiac events among patients with various pretest likelihoods of CAD (p value=0.04). CONCLUSION: Our data confirmed that patients with a normal 99mTc-Sestamibi myocardial SPECT are associated with a very low incidence of cardiovascular events.
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Raziei et al. (2011) conducted a cohort in Suspected coronary artery disease (n=1,047). Normal 99mTc-Sestamibi SPECT myocardial perfusion imaging was evaluated on Hard cardiac events (cardiac death or non-fatal myocardial infarction). A normal stress technetium-99m-Sestamibi SPECT myocardial perfusion scan in patients with suspected coronary artery disease was associated with a very low annualized hard cardiac event rate of 0.28%.
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