Incremental prognostic value of stress/rest gated perfusion SPECT in patients with coronary artery disease -Subanalysis of the J-ACCESS study

Akiyoshi Hashimoto, Tomoaki Nakata, Takeru Wakabayashi, Hideo Kusuoka, Tsunehiko Nishimura

Research output: Contribution to journalArticle

Abstract

Background: This study aimed to reveal the incremental prognostic implications of perfusion/function variables by stress/rest gated single-photon emission computed tomography (SPECT) over clinical risks in patients with known coronary artery disease (CAD). Methods and Results: Using the Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS) database, the 3-year follow-up data of 2,200 patients who had established CAD were analyzed. Major cardiac events (cardiac death, myocardial infarction, heart failure, and unstable angina) were observed in 167 (7.6%) patients. Multivariate logistic regression analysis identified peripheral artery disease, diabetes mellitus, no use of statins, typical chest pain, pharmacological stress test, heart rate at rest, left ventricular end-systolic volume index derived from gated SPECT (LVESVI), and summed difference score (SDS) as independent significant predictors of the major cardiac events, with odds ratios of 1.025 to 2.291 (P=0.0309-0.0008). Global chi-square values increased by combining the independent predictors, and the greatest values (nearly 110) were observed when LVESVI or SDS was added to the pre-scan clinical information. Conclusions: Perfusion/function measures by stress/rest gated SPECT contribute to a significant improvement in risk stratification and secondary prevention strategy in combination with pre-scan clinical risks in patients with known CAD.

Original languageEnglish (US)
Pages (from-to)2288-2293
Number of pages6
JournalCirculation Journal
Volume73
Issue number12
DOIs
StatePublished - 2009

Keywords

  • Coronary artery disease
  • Japanese
  • Prognosis
  • Single-photon emission computed tomography (SPECT)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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