Author/Authors :
Schinkel، نويسنده , , Arend F.L. and Elhendy، نويسنده , , Abdou and Bax، نويسنده , , Jeroen J. and van Domburg، نويسنده , , Ron T. and Huurman، نويسنده , , Aukje and Valkema، نويسنده , , Roelf and Biagini، نويسنده , , Elena and Rizzello، نويسنده , , Vittoria and Feringa، نويسنده , , Harm H. and Krenning، نويسنده , , Eric P. and Simoons، نويسنده , , Maarten L. and Poldermans، نويسنده , , Don، نويسنده ,
Abstract :
Previous studies have shown a good outcome for patients who present with normal findings on stress myocardial perfusion imaging. Currently, the prognostic implications of a normal study in patients who have a history of coronary artery disease (CAD) are not clear. This study investigated the long-term prognosis after a normal finding on stress technetium-99m (Tc-99m)–tetrofosmin single-photon emission computed tomography in patients with a history of CAD. The study included 147 consecutive patients with a history of CAD (previous myocardial infarction and/or myocardial revascularization), who underwent exercise bicycle or high-dose dobutamine-atropine stress Tc-99m–tetrofosmin single-photon emission computed tomography, and had normal perfusion results during stress and at rest. Follow-up was completed in all patients. During a follow-up of 6.5 ± 1.9 years, 20 patients (14%) died, 10 (7%) of whom died due to cardiac causes, and 12 (8%) had a nonfatal myocardial infarction. Annual cardiac death rates were 0.5% during the first 3 years of follow-up and 1.3% in the subsequent 3 years. Independent predictors of cardiac death were male gender, rate–pressure product at rest, and rate–pressure product at peak stress. In conclusion, patients who have a history of CAD have a very low cardiac death rate during the 3 years after a normal finding on stress Tc-99m–tetrofosmin single-photon emission computed tomography. Repeated testing should be reconsidered 3 years after the initial evaluation and when a change in symptoms or clinical condition occurs.
