Document Detail

Independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in coronary artery disease.
MedLine Citation:
PMID:  8354796     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The objective of this study was to examine the independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in patients with angiographically defined coronary artery disease. BACKGROUND: Previous studies showed the importance of exercise thallium-201 in risk stratification. However, most of these studies used planar imaging techniques. METHODS: Follow-up data were obtained in 316 medically treated patients with coronary artery disease. Cox proportional hazards regression models were used to examine the independent and incremental prognostic values of clinical, exercise, thallium and cardiac catheterization data. RESULTS: There were 35 events (cardiac death or nonfatal myocardial infarction) at a mean follow-up time of 28 months. Univariate analysis showed that gender (chi-square = 5.1), exercise work load (chi-square = 3.1), extent of coronary artery disease and left ventricular ejection fraction (chi-square = 14.8) and thallium variables (chi-square = 22.7) were prognostically important. The thallium data provided incremental prognostic value to catheterization data (chi-square = 33.7, p < 0.01). The extent of the perfusion abnormality was the single best predictor of prognosis (chi-square = 14). Patients with a large perfusion abnormality had a worse prognosis than that of patients with a mild or no abnormality (Mantel-Cox statistics = 10.6, p < 0.001). CONCLUSIONS: In medically treated patients with coronary artery disease, exercise SPECT thallium imaging provides independent and incremental prognostic information even when catheterization data are available. The extent of the perfusion abnormality is the single most important prognostic predictor.
A S Iskandrian; S C Chae; J Heo; C D Stanberry; V Wasserleben; V Cave
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  22     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1993-09-23     Completed Date:  1993-09-23     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  665-70     Citation Subset:  AIM; IM    
Philadelphia Heart Institute, Presbyterian Medical Center, Pennsylvania 19104.
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MeSH Terms
Chi-Square Distribution
Coronary Angiography
Coronary Disease / mortality,  radionuclide imaging*
Exercise Test* / methods,  statistics & numerical data
Follow-Up Studies
Heart Catheterization / statistics & numerical data
Middle Aged
Proportional Hazards Models
Survival Analysis
Thallium Radioisotopes / diagnostic use*
Tomography, Emission-Computed, Single-Photon* / methods,  statistics & numerical data
Reg. No./Substance:
0/Thallium Radioisotopes

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