Prognostic value of myocardial perfusion imaging by cadmium zinc telluride single-photon emission computed tomography in patients with suspected or known coronary artery disease: a systematic review and meta-analysis

• Published in: European journal of nuclear medicine and molecular imaging Vol. 50; no. 12; pp. 3647 - 3658
• Main Authors: Assante, Roberta, Zampella, Emilia, Cantoni, Valeria, Green, Roberta, D’Antonio, Adriana, Mannarino, Teresa, Gaudieri, Valeria, Nappi, Carmela, Buongiorno, Pietro, Panico, Mariarosaria, Petretta, Mario, Cuocolo, Alberto, Acampa, Wanda
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2023; Springer Nature B.V
• Subjects: Adverse events; Angina; Cadmium; Cadmium zinc tellurides; Cardiology; Cardiovascular disease; Computed tomography; Confidence intervals; Coronary artery disease; Coronary vessels; Heart diseases; Heterogeneity; Imaging; Intermetallic compounds; Medical imaging; Medical prognosis; Medicine; Medicine & Public Health; Meta-analysis; Nuclear Medicine; Oncology; Original; Original Article; Orthopedics; Perfusion; Photon emission; Photons; Radiology; Regression analysis; Signs and symptoms; Single photon emission computed tomography; Statistical analysis; Tomography; Vein & artery diseases; Zinc telluride; Zinc tellurides; Myocardial perfusion imaging; Coronary artery disease; CZT-SPECT; Outcome; Meta-analysis
• ISSN: 1619-7070; 1619-7089; 1619-7089
• DOI: 10.1007/s00259-023-06344-8

Background Aim of this study was to define the prognostic value of stress myocardial perfusion imaging by cadmium zinc telluride (CZT) single-photon emission computed tomography (SPECT) for prediction of adverse cardiovascular events in patients with known or suspected coronary artery disease (CAD). Methods and results Studies published until November 2022 were identified by database search. We included studies using stress myocardial perfusion imaging by CZT-SPECT to evaluate subjects with known or suspected CAD and providing primary data of adverse cardiovascular events. Total of 12 studies were finally included recruiting 36,415 patients. Pooled hazard ratio (HR) for the occurrence of adverse events was 2.17 (95% confidence interval, CI, 1.78–2.65) and heterogeneity was 66.1% ( P  = 0.001). Five studies reported data on adjusted HR for the occurrence of adverse events. Pooled HR was 1.69 (95% CI, 1.44–1.98) and heterogeneity was 44.9% ( P  = 0.123). Seven studies reported data on unadjusted HR for the occurrence of adverse events. Pooled HR was 2.72 (95% CI, 2.00–3.70). Nine studies reported data useful to calculate separately the incidence rate of adverse events in patients with abnormal and normal myocardial perfusion. Pooled incidence rate ratio was 2.38 (95% CI, 1.39–4.06) and heterogeneity was 84.6% ( P  < 0.001). The funnel plot showed no evidence of asymmetry ( P  = 0.517). At meta-regression analysis, we found an association between HR for adverse events and presence of angina symptoms and family history of CAD. Conclusions Stress myocardial perfusion imaging by CZT-SPECT is a valuable noninvasive prognostic indicator for adverse cardiovascular events in patients with known or suspected CAD.