Document Detail


A normal stress SPECT scan is an effective gatekeeper for coronary angiography.
MedLine Citation:
PMID:  17386380     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Todd D Miller; David O Hodge; James J Milavetz; Raymond J Gibbons
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2007-03-27     Completed Date:  2007-04-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  187-93     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn 55905, USA. miller.todd@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography / 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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