F-18-Fluorodeoxyglucose Positron Emission Tomography Imaging-Assisted Management of Patients With Severe Left Ventricular Dysfunction and Suspected Coronary Disease

• Published in: Journal of the American College of Cardiology 2007-11, Vol.50 (20), p.2002-2012
• Main Authors: Beanlands, Rob S.B., MD, FRCPC, FACC, Nichol, Graham, MD, FRCPC, Huszti, Ella, MSc, Humen, Dennis, MD, FRCPC, FACP, FACC, Racine, Normand, MD, FRCPC, Freeman, Michael, MD, FACC, FRCPC, Gulenchyn, Karen Y., MD, FRCPC, Garrard, Linda, BSc, RN, deKemp, Robert, PhD, Guo, Ann, MEng, Ruddy, Terrence D., MD, FRCPC, FACC, Benard, Francois, MD, FRCPC, Lamy, André, MD, MHSc, Iwanochko, Robert M., MD, FRCPC, FACC
• Format: Article
• Language: English
• Subjects: Cardiovascular; Internal Medicine
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2007.09.006

F-18-Fluorodeoxyglucose Positron Emission Tomography Imaging-Assisted Management of Patients With Severe Left Ventricular Dysfunction and Suspected Coronary Disease: A Randomized, Controlled Trial (PARR-2) Rob S. B. Beanlands, Graham Nichol, Ella Huszti, Dennis Humen, Normand Racine, Michael Freeman, Karen Y. Gulenchyn, Linda Garrard, Robert deKemp, Ann Guo, Terrence D. Ruddy, Francois Benard, André Lamy, Robert M. Iwanochko, the PARR-2 Investigators In a randomized trial, F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET)-assisted management (n = 218) was compared with standard care (n = 212) in patients with severe ventricular dysfunction and suspected coronary disease. Primary outcome was the composite of cardiac death, myocardial infarction, or cardiac recurrent hospital stay within 1 year. Event rates were 30% (PET) versus 36% (standard) (relative risk = 0.82, 95% confidence interval 0.59 to 1.14; p = 0.16). Event-free survival benefit was observed in the PET arm, in those who adhered to recommendations (hazard ratio [HR] = 0.62; p = 0.019), and for cardiac death, in patients without recent angiography (HR = 0.4; p = 0.035). Overall, PET-assisted management did not reduce events versus standard care. The utility of FDG PET is best realized in high-risk patients without recent angiography and when adherence to recommendations can be achieved.