The diagnostic and prognostic value of near-normal perfusion or borderline ischemia on stress myocardial perfusion imaging

AbstractBackgroundData on the diagnostic and prognostic value of subtle abnormalities on myocardial perfusion imaging (MPI) are limited.Methods and resultsIn a retrospective single-center cohort of patients who underwent regadenoson SPECT-MPI, near-normal MPI was defined as normal left ventricular ejection fraction (LVEF  ≥ 50%) and a summed stress score (SSS) of 1-3 vs SSS = 0 in normal MPI. Borderline ischemia was defined as normal LVEF, SSS = 1-3, and a summed difference score (SDS) of 1 vs SDS = 0 in the absence of ischemia. Coronary angiography data within 6 months from MPI were tabulated. Pa tients were followed for cardiac death (CD), myocardial infarction (MI), coronary revascularization (CR), and Late CR (LCR) [>  90 days post MPI]. Among 6,802 patients (mean age, 62 ± 13 years; 42% men), followed for a mean of 2.5 ± 2.1 years, 4,398 had normal MPI, 2,404 had near-normal MPI, and 972 had borderline ischemia. Among patients who underwent angiography within 6 months, obstructive (≥ 70% or l eft main ≥ 50%) CAD was observed at higher rates among subjects with near-normal MPI (33.5% vs 25.5%;P = .049) and those with borderline ischemia (40.5% vs 25.8%;P = .004). During follow-up, 158 (2.3%) CD/MI, 246 (3.6%) CR, and 150 (2.2%) LCR were observed. Near-normal MPI (SSS = 1...
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research

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