Document Detail


Prognostic implications of a normal stress technetium-99m-tetrofosmin myocardial perfusion study in patients with a healed myocardial infarct and/or previous coronary revascularization.
MedLine Citation:
PMID:  16377272     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies have shown a good outcome for patients who present with normal findings on stress myocardial perfusion imaging. Currently, the prognostic implications of a normal study in patients who have a history of coronary artery disease (CAD) are not clear. This study investigated the long-term prognosis after a normal finding on stress technetium-99m (Tc-99m)-tetrofosmin single-photon emission computed tomography in patients with a history of CAD. The study included 147 consecutive patients with a history of CAD (previous myocardial infarction and/or myocardial revascularization), who underwent exercise bicycle or high-dose dobutamine-atropine stress Tc-99m-tetrofosmin single-photon emission computed tomography, and had normal perfusion results during stress and at rest. Follow-up was completed in all patients. During a follow-up of 6.5 +/- 1.9 years, 20 patients (14%) died, 10 (7%) of whom died due to cardiac causes, and 12 (8%) had a nonfatal myocardial infarction. Annual cardiac death rates were 0.5% during the first 3 years of follow-up and 1.3% in the subsequent 3 years. Independent predictors of cardiac death were male gender, rate-pressure product at rest, and rate-pressure product at peak stress. In conclusion, patients who have a history of CAD have a very low cardiac death rate during the 3 years after a normal finding on stress Tc-99m-tetrofosmin single-photon emission computed tomography. Repeated testing should be reconsidered 3 years after the initial evaluation and when a change in symptoms or clinical condition occurs.
Authors:
Arend F L Schinkel; Abdou Elhendy; Jeroen J Bax; Ron T van Domburg; Aukje Huurman; Roelf Valkema; Elena Biagini; Vittoria Rizzello; Harm H Feringa; Eric P Krenning; Maarten L Simoons; Don Poldermans
Publication Detail:
Type:  Journal Article     Date:  2005-11-04
Journal Detail:
Title:  The American journal of cardiology     Volume:  97     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-26     Completed Date:  2006-02-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure
Coronary Artery Disease / mortality,  therapy
Coronary Circulation*
Echocardiography, Stress*
Exercise Test*
Female
Follow-Up Studies
Heart Rate
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / mortality*,  radionuclide imaging,  therapy
Myocardial Revascularization*
Organophosphorus Compounds / diagnostic use
Organotechnetium Compounds / diagnostic use
Prognosis
Radiopharmaceuticals / diagnostic use
Sex Factors
Tomography, Emission-Computed, Single-Photon
Chemical
Reg. No./Substance:
0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane

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