Abstract:
PURPOSE:The aim of the study was to assess the role of myocardial perfusion scintigraphy (MPS) in the prediction of future cardiac events in elderly hypertensive patients and to investigate if its prognostic value is maintained during a 10-year follow-up period. METHODS:A total of 229 consecutive patients ≥ 65 years old (range 65-88 years) with arterial hypertension, who were referred to our institution for stress/rest (99m)Tc-sestamibi MPS between January 2000 and November 2001, were followed up for 10-12 years. Cardiac death, myocardial infarction and a coronary revascularization procedure were considered as events. Survival curves were computed by the Kaplan-Meier method. A stepwise Cox proportional hazards analysis was used to identify predictors of events. RESULTS:Follow-up was completed in 221 (96.5 %) patients; 26 patients experienced cardiac death, 29 myocardial infarction and 51 coronary revascularization. Annual event rates for cardiac death, cardiac death/myocardial infarction and cardiac death/myocardial infarction/coronary revascularization were, respectively, 0, 0.2 and 0.4 % for patients with a normal scan and 1.5, 3.0 and 5.3 % after an abnormal MPS. Event-free survival was significantly different according to extent and severity of perfusion defects (all p < 0.01). An increase in global chi-square in predicting cardiac events occurred when MPS data were added to pre-scan information (from 47.28 to 88.87; p < 0.001). CONCLUSION:MPS provides incremental prognostic information for the prediction of cardiac events in elderly patients with hypertension. Subjects with a normal scan have an excellent 10-year outcome, and the risk of experiencing a cardiac event increases with extension and severity of stress perfusion defect.
journal_name
Eur J Nucl Med Mol Imagingauthors
Nai Fovino L,Saladini G,Cervino AR,Saladini F,Gregianin M,Razzolini R,Evangelista Ldoi
10.1007/s00259-012-2169-xsubject
Has Abstractpub_date
2012-10-01 00:00:00pages
1570-80issue
10eissn
1619-7070issn
1619-7089journal_volume
39pub_type
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