Document Detail


Quantitative gated single-photon emission computed tomography with (99m)Tc sestamibi predicts major cardiac events in elderly patients with known or suspected coronary artery disease: the QGS-Prognostic Value in the Elderly (Q-PROVE) Study.
MedLine Citation:
PMID:  17587706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although electrocardiogram-gated single-photon emission computed tomography (SPECT) may be useful in risk stratification of elderly patients with coronary artery disease (CAD), few studies have prospectively evaluated its prognostic value in this patient population. METHODS AND RESULTS: A total of 175 patients aged 75 years or more with known or suspected CAD were prospectively evaluated by stress gated SPECT using a 20-segment model and an automatic functional analysis. Patients with acute coronary syndrome within the previous 3 months, and those who underwent coronary revascularization within 3 months after the SPECT study were excluded. Outcome assessment included prespecified cardiac events and noncardiac deaths. During a mean follow-up of 3.4 years, there were 18 cardiac events: 2 cardiac deaths, 1 nonfatal myocardial infarction, 3 coronary artery bypass grafting, 5 percutaneous coronary interventions, 1 unstable angina, 4 heart failures, and 2 malignant arrhythmias. Kaplan-Meier survival estimation indicated an event-free survival rate of 98.1% at 3 years in patients without myocardial ischemia, but 79.9% in those with ischemia as documented by gated SPECT (p=0.0001). Multivariate analysis using the Cox proportional hazard model demonstrated that stress-induced myocardial ischemia was the only independent predictor for subsequent cardiac events (p<0.01). CONCLUSIONS: Stress gated SPECT predicts cardiac events in patients aged 75 years or more with known or suspected CAD and may have a role in risk stratification of this patient population.
Authors:
Tadashi Nagao; Taishiro Chikamori; Satoshi Hida; Yuko Igarashi; Yoichi Kuwabara; Shigeyuki Nishimura; Junichi Yamazaki; Akira Yamashina;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  71     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-08-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1029-34     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angina Pectoris / etiology,  radionuclide imaging
Arrhythmias, Cardiac / etiology,  radionuclide imaging
Cardiac Output, Low / etiology,  radionuclide imaging
Coronary Artery Disease / complications,  radionuclide imaging*
Female
Heart Diseases / etiology,  radionuclide imaging*
Humans
Kaplan-Meiers Estimate
Male
Multivariate Analysis
Myocardial Infarction / etiology,  radionuclide imaging
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Radiopharmaceuticals / diagnostic use
Risk Factors
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon / methods*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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