Document Detail


Usefulness of stress myocardial perfusion imaging for evaluating asymptomatic patients after coronary stent implantation.
MedLine Citation:
PMID:  15118289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Stent implantation in coronary angioplasty has reduced the rate of restenosis, but many patients still undergo follow-up coronary angiography (CAG). The present study was a multi-center retrospective analysis of the usefulness of stress single photon emission computed tomography (SPECT) compared with follow-up CAG in stent-implanted patients who remained asymptomatic during the follow-up period. METHODS AND RESULTS: The study group of 103 patients underwent both SPECT and CAG at 4-9 months after stent implantation. Restenosis occurred in 20 (19%) of 106 vessel territories, and a reversible perfusion defect was found in 32 (30%) territories. Sensitivity, specificity, positive and negative predictive values, and accuracy of SPECT were 65%, 78%, 41%, 91%, and 76%, respectively. The accuracy was lower in territories with a prior myocardial infarction (71%), in the left circumflex artery (58%), and in cases with three-vessel disease (63%). The negative predictive value was high, but 7 false negative cases included 4 cases with prior myocardial infarction, and 2 cases with reversible defects in other vessel territories. CONCLUSIONS: Stress SPECT imaging is a useful tool for following up patients with coronary stent implantation, and follow-up CAG could be omitted in patients with negative SPECT imaging, no prior myocardial infarction, one- or two-vessel disease, and sufficient stress loading.
Authors:
Toshihiko Sugi; Hiroshi Satoh; Akihiko Uehara; Hideki Katoh; Hajime Terada; Masaki Matsunaga; Keisuke Yamazaki; Fumitaka Matoh; Tomoyasu Nakano; Shu Yoshihara; Chinori Kurata; Haruo Miyata; Hiroshi Ukigai; Kei Tawarahara; Masahiko Kimura; Shingo Suzuki; Hideharu Hayashi
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  68     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-30     Completed Date:  2004-11-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  462-6     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography*
Coronary Circulation
Coronary Disease / therapy*
Coronary Restenosis / diagnosis*
Exercise Test*
False Negative Reactions
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Stents*
Tomography, Emission-Computed, Single-Photon*

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