| F-18-fluorodeoxyglucose positron emission tomography imaging-assisted management of patients with severe left ventricular dysfunction and suspected coronary disease: a randomized, controlled trial (PARR-2). | |
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MedLine Citation:
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PMID: 17996568 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We conducted a randomized trial to assess the effectiveness of F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET)-assisted management in patients with severe ventricular dysfunction and suspected coronary disease. BACKGROUND: Such patients may benefit from revascularization, but have significant perioperative morbidity and mortality. F-18-fluorodeoxyglucose PET can detect viable myocardium that might recover after revascularization. METHODS: Included were patients with severe left ventricular (LV) dysfunction and suspected coronary disease being considered for revascularization, heart failure, or transplantation work-ups or in whom PET was considered potentially useful. Patients were stratified according to recent angiography or not, then randomized to management assisted by FDG PET (n = 218) or standard care (n = 212). The primary outcome was the composite of cardiac death, myocardial infarction, or recurrent hospital stay for cardiac cause, within 1 year. RESULTS: At 1 year, the cumulative proportion of patients who had experienced the composite event was 30% (PET arm) versus 36% (standard arm) (relative risk 0.82, 95% confidence interval [CI] 0.59 to 1.14; p = 0.16). The hazard ratio (HR) for the composite outcome, PET versus standard care, was 0.78 (95% CI 0.58 to 1.1; p = 0.15); for patients that adhered to PET recommendations for revascularization, revascularization work-up, or neither, HR = 0.62 (95% CI 0.42 to 0.93; p = 0.019); in those without recent angiography, for cardiac death, HR = 0.4 (95% CI 0.17 to 0.96; p = 0.035). CONCLUSIONS: This study did not demonstrate a significant reduction in cardiac events in patients with LV dysfunction and suspected coronary disease for FDG PET-assisted management versus standard care. In those who adhered to PET recommendations and in patients without recent angiography, significant benefits were observed. The utility of FDG PET is best realized in this subpopulation and when adherence to recommendations can be achieved. |
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Authors:
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Rob S B Beanlands; Graham Nichol; Ella Huszti; Dennis Humen; Normand Racine; Michael Freeman; Karen Y Gulenchyn; Linda Garrard; Robert deKemp; Ann Guo; Terrence D Ruddy; Francois Benard; André Lamy; Robert M Iwanochko; |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2007-10-10 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 50 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2007 Nov |
Date Detail:
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Created Date: 2007-11-12 Completed Date: 2007-12-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2002-12 Citation Subset: AIM; IM |
Affiliation:
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National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. rbeanlands@ottawaheart.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Disease / diagnosis, mortality, radionuclide imaging* Death Disease Management Female Fluorodeoxyglucose F18 / diagnostic use* Humans Male Middle Aged Positron-Emission Tomography / methods* Survival Rate Ventricular Dysfunction, Left / diagnosis, mortality, radionuclide imaging* |
| Chemical | |
Reg. No./Substance:
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63503-12-8/Fluorodeoxyglucose F18 |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2007 Nov 13;50(20):2013-5
[PMID:
17996569
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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