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Single-photon emission computed tomography myocardial perfusion defects are associated with an increased risk of all-cause death, cardiovascular death, and sudden cardiac death.

Publication ,  Journal Article
Piccini, JP; Horton, JR; Shaw, LK; Al-Khatib, SM; Lee, KL; Iskandrian, AE; Borges-Neto, S
Published in: Circ Cardiovasc Imaging
November 2008

BACKGROUND: Single-photon emission computed tomography myocardial perfusion imaging defects are associated with increased all-cause mortality and cardiovascular death. However, it is unknown whether single-photon emission computed tomography myocardial perfusion imaging can identify patients at increased risk of sudden cardiac death (SCD). METHODS AND RESULTS: We analyzed a cohort of 6383 patients with angiographically documented coronary artery disease who underwent single-photon emission computed tomography imaging. Cox proportional hazards modeling was used to examine the relationship between patient characteristics and SCD. Among patients who died, the median time to SCD was 2.7 years (25(th), 75(th) percentiles 0.9, 4.9, respectively). The incidence of SCD was 3.4% (n=215) over 6.1 years (25(th), 75(th) percentiles 3.7, 9.2, respectively) of follow-up. Patients with SCD had more severe heart failure symptoms, greater comorbidity (Charlson index), and higher summed stress perfusion scores (all P<0.001). After adjusting for left ventricular ejection fraction and other clinical factors in the multivariable model, the summed stress perfusion score (fixed plus reversible defects) remained significantly associated with the occurrence of SCD: summed stress perfusion score (hazard ratios per 3 U: 1.16 [95% CI, 1.08 to 1.25], P<0.001), left ventricular ejection fraction (hazard ratios per 5 U: 0.90 [95% CI, 0.85 to 0.95], P<0.001), and Charlson index (hazard ratios 1.35 [95% CI, 1.23 to 1.49], P<0.001). CONCLUSIONS: Myocardial perfusion imaging is a significant predictor of SCD and provides information independent of clinical history and left ventricular ejection fraction. Gated single-photon emission computed tomography imaging, which evaluates both myocardial perfusion and function, may represent a more effective means of risk stratification than solitary left ventricular ejection fraction determination and should be evaluated in prospective trials.

Duke Scholars

Published In

Circ Cardiovasc Imaging

DOI

EISSN

1942-0080

Publication Date

November 2008

Volume

1

Issue

3

Start / End Page

180 / 188

Location

United States

Related Subject Headings

  • Tomography, Emission-Computed, Single-Photon
  • Survival Analysis
  • Risk Factors
  • Risk Assessment
  • Myocardial Perfusion Imaging
  • Middle Aged
  • Male
  • Humans
  • Female
  • Death, Sudden, Cardiac
 

Citation

APA
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ICMJE
MLA
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Piccini, J. P., Horton, J. R., Shaw, L. K., Al-Khatib, S. M., Lee, K. L., Iskandrian, A. E., & Borges-Neto, S. (2008). Single-photon emission computed tomography myocardial perfusion defects are associated with an increased risk of all-cause death, cardiovascular death, and sudden cardiac death. Circ Cardiovasc Imaging, 1(3), 180–188. https://doi.org/10.1161/CIRCIMAGING.108.776484
Piccini, Jonathan P., John R. Horton, Linda K. Shaw, Sana M. Al-Khatib, Kerry L. Lee, Ami E. Iskandrian, and Salvador Borges-Neto. “Single-photon emission computed tomography myocardial perfusion defects are associated with an increased risk of all-cause death, cardiovascular death, and sudden cardiac death.Circ Cardiovasc Imaging 1, no. 3 (November 2008): 180–88. https://doi.org/10.1161/CIRCIMAGING.108.776484.
Piccini JP, Horton JR, Shaw LK, Al-Khatib SM, Lee KL, Iskandrian AE, et al. Single-photon emission computed tomography myocardial perfusion defects are associated with an increased risk of all-cause death, cardiovascular death, and sudden cardiac death. Circ Cardiovasc Imaging. 2008 Nov;1(3):180–8.
Piccini, Jonathan P., et al. “Single-photon emission computed tomography myocardial perfusion defects are associated with an increased risk of all-cause death, cardiovascular death, and sudden cardiac death.Circ Cardiovasc Imaging, vol. 1, no. 3, Nov. 2008, pp. 180–88. Pubmed, doi:10.1161/CIRCIMAGING.108.776484.
Piccini JP, Horton JR, Shaw LK, Al-Khatib SM, Lee KL, Iskandrian AE, Borges-Neto S. Single-photon emission computed tomography myocardial perfusion defects are associated with an increased risk of all-cause death, cardiovascular death, and sudden cardiac death. Circ Cardiovasc Imaging. 2008 Nov;1(3):180–188.

Published In

Circ Cardiovasc Imaging

DOI

EISSN

1942-0080

Publication Date

November 2008

Volume

1

Issue

3

Start / End Page

180 / 188

Location

United States

Related Subject Headings

  • Tomography, Emission-Computed, Single-Photon
  • Survival Analysis
  • Risk Factors
  • Risk Assessment
  • Myocardial Perfusion Imaging
  • Middle Aged
  • Male
  • Humans
  • Female
  • Death, Sudden, Cardiac