Warranty periods for normal myocardial perfusion stress SPECT

• Published in: Journal of nuclear cardiology Vol. 22; no. 1; pp. 44 - 54
• Main Authors: Romero-Farina, Guillermo, Candell-Riera, Jaume, Aguadé-Bruix, Santiago, Ferreira-González, Ignacio, Cuberas-Borrós, Gemma, Pizzi, Nazarena, García-Dorado, David
• Format: Journal Article
• Language: English
• Published: Boston Elsevier Inc 01.02.2015; Springer US; Springer Nature B.V
• Subjects: Aged; Cardiology; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - pathology; Diabetes Complications - diagnosis; Dipyridamole - chemistry; dipyridamole myocardial perfusion imaging; Exercise; exercise myocardial perfusion imaging; Exercise Test; Female; Follow-Up Studies; gated-SPECT; Humans; Imaging; Kaplan-Meier Estimate; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - pathology; Myocardial Perfusion Imaging; Nuclear Medicine; Original Article; prognosis; Proportional Hazards Models; Radiology; Time Factors; Tomography, Emission-Computed, Single-Photon; warranty period; exercise myocardial perfusion imaging; warranty period; gated-SPECT; Coronary artery disease; prognosis; dipyridamole myocardial perfusion imaging
• ISSN: 1071-3581; 1532-6551
• DOI: 10.1007/s12350-014-9957-6

To assess different warranty periods following a normal myocardial perfusion SPECT based on patients’ clinical characteristics and the type of stress performed. A study was done of 2,922 consecutive patients (62.9 ± 13 years; 53.4% women) with a normal stress-rest SPECT. The warranty period was defined as the period during which patients remained at a low risk (<1% events/year) of total mortality (TM), or hard events (HE) (cardiac death or non-fatal myocardial infarction). Of these patients, 2,051 were given an exercise myocardial perfusion imaging (Ex-MPI); 461 submaximal exercise plus dipyridamole (Ex+Dipy-MPI); and 410 dipyridamole (Dipy-MPI). During a mean follow-up of 5 ± 3.3 years, a significant reduction (P < .05) of the warranty period for TM (13.5, 9.6 and 8 months) and HE (34.8, 20.5 and 8.2 months) was observed, for Ex-MPI, Ex+Dipy-MPI and Dipy-MPI, respectively. Other warranty period determinants were the clinical variables of age, sex, diabetes and known coronary artery disease. An abnormal left ventricular ejection fraction on gated-SPECT also significantly shortened the warranty period for HE in patients undergoing Ex+Dipy-MPI (P = .001) or Dipy-MPI alone (P = .007). The warranty period for a normal stress-rest SPECT is highly variable since it is primarily determined by the type of stress, the patient’s clinical characteristics and LVEF.