2018 年 4 巻 1 号 p. 123-126
J-ACCESS was the first database created in Japan to assess prognosis of patients with coronary artery disease (CAD) using myocardial perfusion imaging and its quantitation. Four J-ACCESS studies have been completed since 2001, and 4,629 patients who were diagnosed with or suspected of having CAD were registered in the initial study. The J-ACCESS investigations of prognostic databases after stress myocardial perfusion single-photon emission computed tomography (SPECT) between 2004 and 2018, which included patients with diabetes mellitus (J-ACCESS 2), chronic kidney disease (J-ACCESS 3) and coronary revascularization (J-ACCESS 4), uncovered novel findings. Myocardial perfusion defects and left ventricular function were identified as determinants of major cardiac events, and the clinical variables of diabetes and chronic kidney disease (or estimated glomerular filtration rate) were selected as independent predictors of cardiac events. Multivariable risk models can estimate major event risk, and thus stratify patients according to the likelihood of being at low, intermediate, or high risk for CAD.
