Prognostic value of myocardial perfusion SPECT images in combination with the maximal heart rate at exercise testing in Japanese patients with suspected ischemic heart disease : a sub-analysis of J-ACCESS

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Author(s)

    • USAMI Satoru
    • Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine
    • NAKAO Kazuwa
    • Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine
    • NISHIMURA Tsunehiko
    • Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine

Abstract

Objectives We assessed whether a combination of summed stress scores (SSS) using exercise myocardial perfusion SPECT (Ex-SPECT) and maximal heart rate accurately predicts cardiac events through a sub-analysis of J-ACCESS (Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT) which was conducted to evaluate the prognosis of Japanese patients with suspected ischemic heart disease. Methods In J-ACCESS, 2, 373 patients with suspected coronary artery disease not receiving beta-blocker treatment underwent Ex-SPECT. These patients were categorized into the following four groups: Group A [achieved target heart rate (THR) and SSS < 4: n = 631], B (did not achieve THR and SSS < 4: n = 612), C (achieved THR and SSS ≥ 4: n = 570), and D (did not achieve THR and SSS ≥ 4: n = 560). We evaluated the incidence rate of cardiac events including cardiac death, myocardial infarction, and heart failure requiring hospital admission during a 3-year period. Results In Group A, B, C, and D, 9 of 631 (1.4%), 15 of 612 (2.4%), 23 of 570 (4.0%) and 30 of 560 (5.4%) patients experienced cardiac events, respectively. Although the hazard ratio of the SSS ≥ 4 was 2.45 (p < 0.001) and that of the attained THR was 0.69 (p = 0.10) in the multiple Cox regression analysis, Kaplan–Meier curves showed that the cardiac events rate was lower in the order of A, B, C, and D (p < 0.001). Conclusion The combination of SSS using Ex-SPECT and the maximal heart rate is a useful predictor of cardiac events in patients with suspected coronary artery disease.

Journal

  • Annals of Nuclear Medicine

    Annals of Nuclear Medicine 23(10), 849-854, 2009-12-01

    Springer Verlag

References:  27

Cited by:  2

Codes

  • NII Article ID (NAID)
    10026099641
  • NII NACSIS-CAT ID (NCID)
    AA10708017
  • Text Lang
    ENG
  • Article Type
    Journal Article
  • ISSN
    09147187
  • Data Source
    CJP  CJPref  IR 
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