Prognostic predictors and outcomes in patients with abnormal myocardial perfusion imaging and angiographically insignificant coronary artery disease

Fadi Alqaisi, Firas AlBadarin, Zehra Jaffery, Leonidas Tzogias, Muath Dawod, Gordon Jacobsen, Karthik Ananthasubramaniam

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Abnormal stress myocardial perfusion imaging studies (SMPI) with angiographically insignificant coronary artery disease (ICAD) have often been labeled "false positive" scans. We evaluated the prognostic predictors and outcomes in an unselected patient population having abnormal SMPI and ICAD (study group) over a 24 month period of follow-up. Methods: Retrospective study of consecutive patients who had SMPI and subsequent coronary angiography showing ICAD within 6 months of index scan with matched control group with normal scans. Major Adverse Cardiac Events (MACE) were defined as the first occurrence of death or myocardial infarction (MI). Patients were followed up to 24 months from the time of their SMPI to identify the development of MACE. Results: One hundred and twenty five patients formed the study group and one hundred and thirty six patients formed the control group. Over a two-year follow up, approximately 13% of the study group had MACE as compared to 4.2% in the control group (P = .022). Abnormal SMPI, EF < 40% and chronic kidney disease (GFR < 60 ml/min) were independent predictors of MACE in the study group. In multivariate analysis for MACE prediction, chronic kidney disease remained the sole independent predictor regardless of size or severity of perfusion abnormalities (P = <.001). Conclusion: Patients with abnormal SMPI and ICAD have a 13% event rate of MACE over a two-year follow up. CKD seems a very important marker of a higher risk subgroup amongst such patients.

Original languageEnglish (US)
Pages (from-to)754-761
Number of pages8
JournalJournal of Nuclear Cardiology
Volume15
Issue number6
DOIs
StatePublished - Nov 2008
Externally publishedYes

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Myocardial Perfusion Imaging
Coronary Artery Disease
Chronic Renal Insufficiency
Control Groups
Coronary Angiography
Research Design
Multivariate Analysis
Retrospective Studies
Perfusion
Myocardial Infarction
Population

Keywords

  • chronic kidney disease
  • coronary artery disease
  • major adverse cardiac events
  • Stress myocardial perfusion imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Prognostic predictors and outcomes in patients with abnormal myocardial perfusion imaging and angiographically insignificant coronary artery disease. / Alqaisi, Fadi; AlBadarin, Firas; Jaffery, Zehra; Tzogias, Leonidas; Dawod, Muath; Jacobsen, Gordon; Ananthasubramaniam, Karthik.

In: Journal of Nuclear Cardiology, Vol. 15, No. 6, 11.2008, p. 754-761.

Research output: Contribution to journalArticle

Alqaisi, Fadi ; AlBadarin, Firas ; Jaffery, Zehra ; Tzogias, Leonidas ; Dawod, Muath ; Jacobsen, Gordon ; Ananthasubramaniam, Karthik. / Prognostic predictors and outcomes in patients with abnormal myocardial perfusion imaging and angiographically insignificant coronary artery disease. In: Journal of Nuclear Cardiology. 2008 ; Vol. 15, No. 6. pp. 754-761.
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AB - Background: Abnormal stress myocardial perfusion imaging studies (SMPI) with angiographically insignificant coronary artery disease (ICAD) have often been labeled "false positive" scans. We evaluated the prognostic predictors and outcomes in an unselected patient population having abnormal SMPI and ICAD (study group) over a 24 month period of follow-up. Methods: Retrospective study of consecutive patients who had SMPI and subsequent coronary angiography showing ICAD within 6 months of index scan with matched control group with normal scans. Major Adverse Cardiac Events (MACE) were defined as the first occurrence of death or myocardial infarction (MI). Patients were followed up to 24 months from the time of their SMPI to identify the development of MACE. Results: One hundred and twenty five patients formed the study group and one hundred and thirty six patients formed the control group. Over a two-year follow up, approximately 13% of the study group had MACE as compared to 4.2% in the control group (P = .022). Abnormal SMPI, EF < 40% and chronic kidney disease (GFR < 60 ml/min) were independent predictors of MACE in the study group. In multivariate analysis for MACE prediction, chronic kidney disease remained the sole independent predictor regardless of size or severity of perfusion abnormalities (P = <.001). Conclusion: Patients with abnormal SMPI and ICAD have a 13% event rate of MACE over a two-year follow up. CKD seems a very important marker of a higher risk subgroup amongst such patients.

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