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J Nucl Med. 2008; 49 (Supplement 1):200P
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Cardiovascular: Clinical Science

Clinical Science Posters

The frequency of ischemia and clinical outcomes in asymptomatic patients with atrial fibrillation referred for myocardial perfusion imaging

Mouaz Al-Mallah1, Rory Hachamovitch2, Sharmila Dorbala3, Raymond Kwong4 and Marcelo Di Carli3

1 Medicine/Cardiology, Henry Ford Hospital, Detroit, Michigan; 2 University of Southern California, Los Angeles, California; 3 Radiology; 4 Cardiology, Brigham and Women's Hospital, Boston, Massachusetts

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Objectives: The prevalence of coronary artery disease (CAD) in asymptomatic patients with atrial fibrillation (AF) is not well described. In addition, the utility of single photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in this population has not been demonstrated. The aim of this study is to examine the diagnostic and prognostic value of SPECT-MPI in asymptomatic AF patients without known CAD.

Methods: Retrospective study of 200 consecutive asymptomatic AF patients without known CAD (mean age 63.1 years, 68% male) referred for SPECT-MPI. The study group was compared to 3353 asymptomatic patients without known CAD or AF. Patients were followed up for all-cause mortality.

Results: Cardiac risk factors for the AF and non-AF group were as follows: diabetes (21% vs. 20, p=NS); hypertension (67% vs. 63%, p=NS) and hyperlipidemia (51% vs. 45%, p=NS). Patients with AF had less often exercise stress tests (49% vs. 62%, p<.001). There was a higher prevalence of abnormal SPECT-MPI studies among AF patients (26% vs. 18%; p=<.001) with no difference in the number of high risk scans (10.5% vs. 7.6%, p=0.14). After excluding patients with early revascularization, all cause mortality was significantly greater in patients with AF (9% vs. 5%, p=.02). An abnormal SPECT MPI was an independent predictor of all cause mortality (HR=1.4, p=0.01) after adjusting for confounders, while AF was not (p=.29).

Conclusions: The prevalence of CAD in asymptomatic AF patients is higher than patients without AF. However, this difference did not appear to translate into significant outcome differences.





This Article
Services
Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Google Scholar
Right arrow Articles by Al-Mallah, M.
Right arrow Articles by Di Carli, M.
PubMed
Right arrow Articles by Al-Mallah, M.
Right arrow Articles by Di Carli, M.