Prognostic value of thallium-201 single-photon emission computed tomography for patients with multivessel coronary artery disease after revascularization (the Emory Angioplasty versus Surgery Trial [EAST])

• Published in: The American journal of cardiology 1999-12, Vol.84 (12), p.1369-1374
• Main Authors: Alazraki, Naomi P, Krawczynska, Elizabeth G, Kosinski, Andrzej S, DePuey, E.Gordon, Ziffer, Jack A, Taylor, Andrew T, Pettigrew, Roderic I, Vansant, Johnathan P, Shaw, Leslee J, Weintraub, William S, King, Spencer B
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty, Balloon, Coronary; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Cause of Death; Clinical trials; Coronary Artery Bypass; Coronary Circulation - physiology; Coronary Disease - diagnostic imaging; Coronary Disease - mortality; Coronary Disease - surgery; Coronary heart disease; Exercise Test; Follow-Up Studies; Graft Occlusion, Vascular - diagnostic imaging; Graft Occlusion, Vascular - mortality; Heart; Humans; Medical sciences; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - mortality; Postoperative Complications - diagnostic imaging; Postoperative Complications - mortality; Prognosis; Survival Rate; Thallium Radioisotopes; Tomography; Tomography, Emission-Computed, Single-Photon
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(99)00578-0

The aim of this study was to investigate the relation between reversible thallium single-photon emission computed tomography (SPECT) myocardial perfusion defects at 1-year after revascularization and quantitative indexes in Emory Angioplasty versus Surgery Trial (EAST) and outcomes 3 years after revascularization in 336 patients. EAST was a randomized controlled trial assessing cardiac outcomes for angioplasty versus bypass surgery for patients with multivessel coronary artery disease. During this prospective trial, a substudy included the evaluation of the prognostic value of reversible defects on quantitative thallium SPECT. At 1-year after revascularization, 336 patients underwent SPECT thallium-201 stress myocardial perfusion and 3-hour delayed imaging. Subsequent events, percutaneous transluminal coronary angioplasty, coronary artery bypass graft surgery, myocardial infarction, and death, were recorded at 3 years. A stress-induced reversible thallium-201 defect was defined using a quantitative index of a reversibility score >30% and severity score >500. Reversible defects were observed more frequently in the percutaneous transluminal coronary angioplasty than in the coronary artery bypass graft surgery treatment groups (46% vs 27%, p