Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Clinical Investigation
Incremental Prognostic Value of Cardiac Function Assessed by ECG-Gated Myocardial Perfusion SPECT for the Prediction of Future Acute Coronary Syndrome
Naoya MatsumotoYuichi SatoYasuyuki SuzukiShu KasamaYoshimochi NakanoMasahiko KatoShunichi YodaTakaaki MikiJun IidaTaeko KunimasaFutoshi TadeharaKen NagaoAtsushi Hirayama
Author information

2008 Volume 72 Issue 12 Pages 2035-2039


Background The prognostic value of ECG-gated rest 201Tl/stress 99mTc-tetrofosmin myocardial perfusion single-photon emission computed tomography for the prediction of acute coronary syndrome (ACS: myocardial infarction (MI) and unstable angina (UA)) and the implications of ejection fraction (EF) has not yet been defined in Japanese. Methods and Results The 1,895 patients were followed up for the occurrence ACS. The mean follow-up interval was 26.9±15.5 months. The 142 patients with revascularization within 60 days were censored. Summed stress score (SSS) and summed difference score (SDS) were calculated. The 19 MI and 29 UA occurred (1.1% and 1.6%, respectively). Univariate Cox analysis showed that hypertension (Wald 5.09, p<0.05), poststress EF (Wald 10.9, p<0.01), SSS (Wald 12.4, p<0.001) and SDS (Wald 18.7, p<0.001) were significant predictors of ACS. Multivariate Cox analysis showed that hypertension (Wald 4.27, p<0.05) and SDS (Wald 8.59, p<0.01) were independent predictors. When multiple clinical risk factors (number of coronary risk factors ≥2), significant ischemia (SDS ≥4) and low EF (EF <45%) were applied to multivariate Cox analysis, the combination of significant ischemia and low EF showed the highest predictive value (Wald 11.9; p<0.001) for future ACS. Conclusion Poststress EF added incremental prognostic value for the prediction of ACS. (Circ J 2008; 72: 2035 - 2039)

Content from these authors
Previous article Next article