The prognostic value of regadenoson SPECT myocardial perfusion imaging: The largest cohort to date.

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Citation: Journal of Nuclear Cardiology. 28(6):2799-2807, 2021 12.PMID: 32383079Institution: MedStar Union Memorial HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Myocardial Perfusion Imaging/mt [Methods] | *Purines | *Pyrazoles | *Tomography, Emission-Computed, Single-Photon/mt [Methods] | Aged | Cohort Studies | Female | Humans | Male | Middle Aged | Myocardial Infarction/dg [Diagnostic Imaging] | Myocardial Ischemia/dg [Diagnostic Imaging] | Prognosis | Retrospective StudiesYear: 2021Local holdings: Available online from MWHC library: 1995 - presentISSN:
  • 1071-3581
Name of journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyAbstract: BACKGROUND: Data on the prognostic value of regadenoson SPECT myocardial perfusion imaging (MPI) is limited and based on small cohorts.CONCLUSION: In the largest cohort to date, we demonstrated that the presence and severity of perfusion abnormality and myocardial ischemia on regadenoson stress SPECT-MPI are associated with an independent increase in MACE.METHODS AND RESULTS: We conducted a single-center, retrospective cohort study of 10,275 consecutive patients who underwent regadenoson SPECT-MPI. Among the study subjects, 28.7% had abnormal MPI and 25.5% had myocardial ischemia. Patients were followed for a mean of 2.4 +/- 2.2 years for major adverse cardiac events (MACE), defined as cardiac death or myocardial infarction. There was a significant stepwise increase in MACE with an increasing burden of perfusion abnormality (P < .001) and myocardial ischemia (P < .001). Abnormal MPI (adjusted HR 1.52; 95% CI 1.21 to 1.91) and myocardial ischemia (adjusted HR 1.53; 95% CI 1.25 to 1.89) were associated with MACE, independent of and incremental to clinical covariates and left ventricular ejection fraction (LVEF). Moreover, post-stress LVEF, LVEF reserve, and left ventricular end-diastolic volume added significant prognostic information. Transient ischemic dilation >= 1.31 did not provide incremental prognostic value (adjusted HR 1.02; P = .906).All authors: Diep L, Doukky R, Iskander F, Iskander M, Kattoor AJ, Khan R, Kolkailah AAOriginally published: Journal of Nuclear Cardiology. 2020 May 07Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2020-07-09
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Journal Article MedStar Authors Catalog Article 32383079 Available 32383079

Available online from MWHC library: 1995 - present

BACKGROUND: Data on the prognostic value of regadenoson SPECT myocardial perfusion imaging (MPI) is limited and based on small cohorts.

CONCLUSION: In the largest cohort to date, we demonstrated that the presence and severity of perfusion abnormality and myocardial ischemia on regadenoson stress SPECT-MPI are associated with an independent increase in MACE.

METHODS AND RESULTS: We conducted a single-center, retrospective cohort study of 10,275 consecutive patients who underwent regadenoson SPECT-MPI. Among the study subjects, 28.7% had abnormal MPI and 25.5% had myocardial ischemia. Patients were followed for a mean of 2.4 +/- 2.2 years for major adverse cardiac events (MACE), defined as cardiac death or myocardial infarction. There was a significant stepwise increase in MACE with an increasing burden of perfusion abnormality (P < .001) and myocardial ischemia (P < .001). Abnormal MPI (adjusted HR 1.52; 95% CI 1.21 to 1.91) and myocardial ischemia (adjusted HR 1.53; 95% CI 1.25 to 1.89) were associated with MACE, independent of and incremental to clinical covariates and left ventricular ejection fraction (LVEF). Moreover, post-stress LVEF, LVEF reserve, and left ventricular end-diastolic volume added significant prognostic information. Transient ischemic dilation >= 1.31 did not provide incremental prognostic value (adjusted HR 1.02; P = .906).

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