Long-term prognostic value of low-dose normal stress-only myocardial perfusion imaging by wide beam reconstruction

A competing risk analysis

Carmela Nappi, Wanda Acampa, Emanuele Nicolai, Stefania Daniele, Emilia Zampella, Roberta Assante, Valeria Gaudieri, Teresa Mannarino, Mario Petretta, Alberto Cuocolo

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: A normal stress myocardial perfusion single-photon emission computed tomography (MPS) is associated with a good clinical outcome. New iterative algorithms, such as wide beam reconstruction (WBR), which improve image interpretation with half-dose or half-time acquisition, have been proposed for cardiac MPS. The aim of this study was to assess the long-term predictive value of a low-dose normal stress-only MPS with WBR using conventional Anger camera in patients with known or suspected coronary artery disease (CAD). Methods and Results: A total of 2106 patients with known or suspected CAD and normal perfusion at half-dose stress-only MPS protocol were followed for a mean of 6.6 ± 2.7 years. MPS data were reconstructed with WBR iterative algorithm. End-point events were cardiac death or nonfatal myocardial infarction. Noncardiac death was considered the competing event. During follow-up, 149 cardiac events occurred with an annualized event rate of 1.2%. Independent predictors of cardiac events at Cox analysis were age, male gender, diabetes mellitus, previous myocardial infarction and the need for pharmacologic stress testing. At Fine-Gray analysis the cumulative incidence of cardiac events progressively increases with age and in the presence of diabetes for any combination of gender and stress type. Survival tree analysis confirmed that long-term prognosis considerably varies according of risk factors profile. Conclusions: Low-dose normal stress-only WBR MPS has a reliable long-term prognostic value in patients with suspected or known CAD. This finding supports the introduction of such a method into clinical practice with a consistent dose optimization in the interest of patients and exposed staff.

Original languageEnglish
JournalJournal of Nuclear Cardiology
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Myocardial Perfusion Imaging
Coronary Artery Disease
Perfusion
Myocardial Infarction
Anger
Survival Analysis
Single-Photon Emission-Computed Tomography
Diabetes Mellitus
Incidence

Keywords

  • diagnostic and prognostic application
  • MPI
  • SPECT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Long-term prognostic value of low-dose normal stress-only myocardial perfusion imaging by wide beam reconstruction : A competing risk analysis. / Nappi, Carmela; Acampa, Wanda; Nicolai, Emanuele; Daniele, Stefania; Zampella, Emilia; Assante, Roberta; Gaudieri, Valeria; Mannarino, Teresa; Petretta, Mario; Cuocolo, Alberto.

In: Journal of Nuclear Cardiology, 01.01.2018.

Research output: Contribution to journalArticle

Nappi, Carmela ; Acampa, Wanda ; Nicolai, Emanuele ; Daniele, Stefania ; Zampella, Emilia ; Assante, Roberta ; Gaudieri, Valeria ; Mannarino, Teresa ; Petretta, Mario ; Cuocolo, Alberto. / Long-term prognostic value of low-dose normal stress-only myocardial perfusion imaging by wide beam reconstruction : A competing risk analysis. In: Journal of Nuclear Cardiology. 2018.
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AU - Acampa, Wanda

AU - Nicolai, Emanuele

AU - Daniele, Stefania

AU - Zampella, Emilia

AU - Assante, Roberta

AU - Gaudieri, Valeria

AU - Mannarino, Teresa

AU - Petretta, Mario

AU - Cuocolo, Alberto

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N2 - Background: A normal stress myocardial perfusion single-photon emission computed tomography (MPS) is associated with a good clinical outcome. New iterative algorithms, such as wide beam reconstruction (WBR), which improve image interpretation with half-dose or half-time acquisition, have been proposed for cardiac MPS. The aim of this study was to assess the long-term predictive value of a low-dose normal stress-only MPS with WBR using conventional Anger camera in patients with known or suspected coronary artery disease (CAD). Methods and Results: A total of 2106 patients with known or suspected CAD and normal perfusion at half-dose stress-only MPS protocol were followed for a mean of 6.6 ± 2.7 years. MPS data were reconstructed with WBR iterative algorithm. End-point events were cardiac death or nonfatal myocardial infarction. Noncardiac death was considered the competing event. During follow-up, 149 cardiac events occurred with an annualized event rate of 1.2%. Independent predictors of cardiac events at Cox analysis were age, male gender, diabetes mellitus, previous myocardial infarction and the need for pharmacologic stress testing. At Fine-Gray analysis the cumulative incidence of cardiac events progressively increases with age and in the presence of diabetes for any combination of gender and stress type. Survival tree analysis confirmed that long-term prognosis considerably varies according of risk factors profile. Conclusions: Low-dose normal stress-only WBR MPS has a reliable long-term prognostic value in patients with suspected or known CAD. This finding supports the introduction of such a method into clinical practice with a consistent dose optimization in the interest of patients and exposed staff.

AB - Background: A normal stress myocardial perfusion single-photon emission computed tomography (MPS) is associated with a good clinical outcome. New iterative algorithms, such as wide beam reconstruction (WBR), which improve image interpretation with half-dose or half-time acquisition, have been proposed for cardiac MPS. The aim of this study was to assess the long-term predictive value of a low-dose normal stress-only MPS with WBR using conventional Anger camera in patients with known or suspected coronary artery disease (CAD). Methods and Results: A total of 2106 patients with known or suspected CAD and normal perfusion at half-dose stress-only MPS protocol were followed for a mean of 6.6 ± 2.7 years. MPS data were reconstructed with WBR iterative algorithm. End-point events were cardiac death or nonfatal myocardial infarction. Noncardiac death was considered the competing event. During follow-up, 149 cardiac events occurred with an annualized event rate of 1.2%. Independent predictors of cardiac events at Cox analysis were age, male gender, diabetes mellitus, previous myocardial infarction and the need for pharmacologic stress testing. At Fine-Gray analysis the cumulative incidence of cardiac events progressively increases with age and in the presence of diabetes for any combination of gender and stress type. Survival tree analysis confirmed that long-term prognosis considerably varies according of risk factors profile. Conclusions: Low-dose normal stress-only WBR MPS has a reliable long-term prognostic value in patients with suspected or known CAD. This finding supports the introduction of such a method into clinical practice with a consistent dose optimization in the interest of patients and exposed staff.

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