Influence of Mode of Stress and Coronary Risk Factor Burden Upon Long-Term Mortality Following Normal Stress Myocardial Perfusion Single-Photon Emission Computed Tomographic Imaging

In patients with normal results on stress single-photon emission computed tomographic (SPECT) studies, coronary artery disease risk factors (RFs) and the mode of testing can influence the trajectory of long-term outcomes. Nevertheless, the combined prognostic impact of these commonly assessed factor...

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Bibliographic Details
Published in:The American journal of cardiology 2013-03, Vol.111 (6), p.846-850
Main Authors: Supariwala, Azhar, MD, Uretsky, Seth, MD, Depuey, E. Gordon, MD, Thotakura, Gargi, MD, Kanneganti, Sirisha, MD, Guriginjakunta, Narasimhanaidu, MD, Vala, Radhika, MD, Kuruba, Mahesh, MD, Rozanski, Alan, MD
Format: Article
Language:English
Subjects:
Age
Aged
Analysis of Variance
Blood pressure
Body mass index
Cardiovascular
Cardiovascular disease
Cause of Death
Chi-Square Distribution
Comorbidity
Confidence intervals
Coronary Disease - diagnostic imaging
Coronary Disease - mortality
Coronary Disease - physiopathology
Diabetes
Ethnicity
Exercise Test
Family medical history
Female
Follow-Up Studies
Gender
Heart attacks
Heart rate
Humans
Male
Middle Aged
Mortality
Multivariate analysis
Myocardial Perfusion Imaging - methods
Pain
Prognosis
Proportional Hazards Models
Radiopharmaceuticals
Retrospective Studies
Risk assessment
Risk Factors
Survival Analysis
Technetium Tc 99m Sestamibi
Tomography, Emission-Computed, Single-Photon
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Summary:In patients with normal results on stress single-photon emission computed tomographic (SPECT) studies, coronary artery disease risk factors (RFs) and the mode of testing can influence the trajectory of long-term outcomes. Nevertheless, the combined prognostic impact of these commonly assessed factors has heretofore not been considered. In this study, all-cause mortality rates were assessed in 5,762 patients with normal results on stress SPECT studies. Patients were divided according to mode of stress testing, exercise or pharmacologic, and by number of coronary artery disease RFs. Patients were followed for a mean of 8 ± 4.2 years for all-cause mortality. There were 1,051 deaths (18%), with an annualized mortality rate of 2.2% per year. The RF-adjusted event rate was significantly higher for pharmacologic versus exercise SPECT studies (3.6% per year vs 1.2% per year, p 
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2012.11.040