| A normal stress SPECT scan is an effective gatekeeper for coronary angiography. | |
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MedLine Citation:
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PMID: 17386380 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The effectiveness of stress single photon emission computed tomography (SPECT) as a gatekeeper for coronary angiography has not been extensively investigated. The characteristics of patients referred for early angiography after a normal stress SPECT study have not been described. METHODS AND RESULTS: Over a 10-year period, 14,273 patients without documented coronary artery disease (CAD) underwent stress SPECT. Images were abnormal in 47% and normal in 53%. The overall survival rate at 15 years was 55% for patients with abnormal images versus 71% for those with normal images (P < .001). Early coronary angiography (< or =3 months) was performed in only 97 patients (1.3%) with normal SPECT studies versus 1,756 patients (26%) with abnormal SPECT studies (P < .001). Most patients with normal SPECT studies referred for early angiography (85%) had clinical, exercise, or scintigraphic findings worrisome for CAD. Two thirds of these highly selected patients with normal SPECT studies who underwent angiography did not have significant CAD; the remaining one third had primarily 1- and 2-vessel CAD. CONCLUSIONS: Stress SPECT is an effective gatekeeper for coronary angiography. The annual overall mortality rate for patients with normal images was 1.9%. Only 1.3% of patients with normal images were referred for early angiography. |
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Authors:
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Todd D Miller; David O Hodge; James J Milavetz; Raymond J Gibbons |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology Volume: 14 ISSN: 1532-6551 ISO Abbreviation: J Nucl Cardiol Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-03-27 Completed Date: 2007-04-19 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9423534 Medline TA: J Nucl Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 187-93 Citation Subset: IM |
Affiliation:
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Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn 55905, USA. miller.todd@mayo.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Angiography
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statistics & numerical data* Coronary Artery Disease / diagnosis*, mortality* Exercise Test / statistics & numerical data* Female Humans Incidence Male Middle Aged Referral and Consultation / statistics & numerical data* Retrospective Studies Risk Assessment / methods* Risk Factors Survival Analysis Survival Rate Tomography, Emission-Computed, Single-Photon / statistics & numerical data* United States / epidemiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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