Independent prognostic value of intravenous dipyridamole with technetium-99m sestamibi tomographic imaging in predicting cardiac events and cardiac-related hospital admissions

Gary V. Heller, Steven D. Herman, Mark I. Travin, John I. Baron, Carlo Santos-Ocampo, Joseph R. Mcclellan

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Objectives.: This study sought to establish the prognostic value of intravenous dipyridamole technetium-99m (Tc-99m) sestamibi single-photon emission computed tomographic (SPECT) myocardial perfusion imaging. Background.: Optimal management of patients with coronary artery disease involves strategies designed to reduce the risk of myocardial infarction and cardiac death. The role of myocardial perfusion imaging using newer clinical techniques to determine risk and possible benefit from therapy has not been evaluated. Methods.: Myocardial imaging results were classified as normal or abnormal (fixed or reversible defects; small, moderate or large). Follow-up evaluation of all patients included the occurrence of cardiac death or nonfatal myocardial infarction and other cardiac-related hospital admissions. Results.: During a mean (±SD) follow-up period of 12.8 ± 6.8 months in 512 patients, 25 had a cardiac event. Patients with abnormal perfusion had significantly more cardiac events than those with normal perfusion (22 vs. 3, p < 0.01). Patients with reversible defects had the highest event rates (8.6%), and those with normal study results had a very low event rate (1.4%). Large defects were strongly associated with more cardiac events and hospital admissions than either normal scan results or abnormal results showing small defects. Conclusions.: Patients with normal study results or a small defect after intravenous dipyridamole Tc-99m sestamibi SPECT imaging had an excellent short-term prognosis. Those with abnormal results (reversible or large defect) had an increased risk of subsequent cardiac death, nonfatal myocardial infarction and other cardiac-related hospital admissions.

Original languageEnglish (US)
Pages (from-to)1202-1208
Number of pages7
JournalJournal of the American College of Cardiology
Volume26
Issue number5
DOIs
StatePublished - Nov 1 1995
Externally publishedYes

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Technetium Tc 99m Sestamibi
Dipyridamole
Myocardial Perfusion Imaging
Myocardial Infarction
Photons
Perfusion
Coronary Artery Disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Nursing(all)

Cite this

Independent prognostic value of intravenous dipyridamole with technetium-99m sestamibi tomographic imaging in predicting cardiac events and cardiac-related hospital admissions. / Heller, Gary V.; Herman, Steven D.; Travin, Mark I.; Baron, John I.; Santos-Ocampo, Carlo; Mcclellan, Joseph R.

In: Journal of the American College of Cardiology, Vol. 26, No. 5, 01.11.1995, p. 1202-1208.

Research output: Contribution to journalArticle

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abstract = "Objectives.: This study sought to establish the prognostic value of intravenous dipyridamole technetium-99m (Tc-99m) sestamibi single-photon emission computed tomographic (SPECT) myocardial perfusion imaging. Background.: Optimal management of patients with coronary artery disease involves strategies designed to reduce the risk of myocardial infarction and cardiac death. The role of myocardial perfusion imaging using newer clinical techniques to determine risk and possible benefit from therapy has not been evaluated. Methods.: Myocardial imaging results were classified as normal or abnormal (fixed or reversible defects; small, moderate or large). Follow-up evaluation of all patients included the occurrence of cardiac death or nonfatal myocardial infarction and other cardiac-related hospital admissions. Results.: During a mean (±SD) follow-up period of 12.8 ± 6.8 months in 512 patients, 25 had a cardiac event. Patients with abnormal perfusion had significantly more cardiac events than those with normal perfusion (22 vs. 3, p < 0.01). Patients with reversible defects had the highest event rates (8.6{\%}), and those with normal study results had a very low event rate (1.4{\%}). Large defects were strongly associated with more cardiac events and hospital admissions than either normal scan results or abnormal results showing small defects. Conclusions.: Patients with normal study results or a small defect after intravenous dipyridamole Tc-99m sestamibi SPECT imaging had an excellent short-term prognosis. Those with abnormal results (reversible or large defect) had an increased risk of subsequent cardiac death, nonfatal myocardial infarction and other cardiac-related hospital admissions.",
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AU - Santos-Ocampo, Carlo

AU - Mcclellan, Joseph R.

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AB - Objectives.: This study sought to establish the prognostic value of intravenous dipyridamole technetium-99m (Tc-99m) sestamibi single-photon emission computed tomographic (SPECT) myocardial perfusion imaging. Background.: Optimal management of patients with coronary artery disease involves strategies designed to reduce the risk of myocardial infarction and cardiac death. The role of myocardial perfusion imaging using newer clinical techniques to determine risk and possible benefit from therapy has not been evaluated. Methods.: Myocardial imaging results were classified as normal or abnormal (fixed or reversible defects; small, moderate or large). Follow-up evaluation of all patients included the occurrence of cardiac death or nonfatal myocardial infarction and other cardiac-related hospital admissions. Results.: During a mean (±SD) follow-up period of 12.8 ± 6.8 months in 512 patients, 25 had a cardiac event. Patients with abnormal perfusion had significantly more cardiac events than those with normal perfusion (22 vs. 3, p < 0.01). Patients with reversible defects had the highest event rates (8.6%), and those with normal study results had a very low event rate (1.4%). Large defects were strongly associated with more cardiac events and hospital admissions than either normal scan results or abnormal results showing small defects. Conclusions.: Patients with normal study results or a small defect after intravenous dipyridamole Tc-99m sestamibi SPECT imaging had an excellent short-term prognosis. Those with abnormal results (reversible or large defect) had an increased risk of subsequent cardiac death, nonfatal myocardial infarction and other cardiac-related hospital admissions.

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