Prognostic value of quantitative stress myocardial perfusion imaging in unstable angina patients with negative cardiac enzymes and no new ischemic ECG changes. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Limited data are available on the value of quantitative stress myocardial perfusion imaging (MPI) in patients with unstable angina. In this report we sought to study the long-term prognostic value of quantitative stress MPI in patients hospitalized with unstable angina with no new ischemic electrocardiographic changes and negative cardiac enzymes. METHODS AND RESULTS: The study population consisted of 136 patients who were hospitalized at the Methodist Hospital, Houston, Tex, with unstable angina and subsequently underwent MPI before discharge. Cox proportional hazards (regression) analysis was performed to identify clinical and MPI predictors of hard cardiac events (death or nonfatal myocardial infarction). During a mean follow-up of 31 +/- 17 months, 20 patients (15%) sustained either cardiac death (n = 12) or nonfatal myocardial infarction (n = 8). The significant multivariate predictors of cardiac events were the total perfusion defect size ( P = .002), the presence of reversible perfusion defects ( P = .01), and the presence of multiple perfusion defects ( P = .03). The perfusion defect size was significantly larger in patients with events than in those without events (21% +/- 20% vs 12% +/- 14%, P = .002). Kaplan-Meier analysis showed that cardiac events were much more likely to develop in patients with defects involving 15% or more of the left ventricle than in those with defects involving less than 15% of the left ventricle ( P = .003). CONCLUSIONS: In patients hospitalized with unstable angina with no new ischemic electrocardiographic changes and negative cardiac enzymes, quantitative stress MPI provides powerful prognostic information that can be used in the risk stratification of these patients.

publication date

  • January 1, 2005

Research

keywords

  • Angina, Unstable
  • Exercise Test
  • Myocardial Infarction
  • Risk Assessment

Identity

Scopus Document Identifier

  • 12744281213

Digital Object Identifier (DOI)

  • 10.1016/j.nuclcard.2004.10.001

PubMed ID

  • 15682363

Additional Document Info

volume

  • 12

issue

  • 1