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Value of calcium score and myocardial perfusion SPECT in the prediction of severe cardiac events during long term follow-up in patients with known coronary artery disease

¹ Nuclear Medicine; ² Cardiology; ³ Radiology, University of Munich, Munich, Germany

302

Objectives: Myocardial perfusion SPECT (MPI) is useful for risk stratification in patients with suspected or known coronary artery disease (CAD). Coronary calcium scores (CACS) are frequently determined in terms of patient screening or CAD exclusion. Aim of the present study was to evaluate the additional prognostic value of CACS compared to MPI in a long term follow up of patients with known CAD.

Methods: 260 patients (174 male, 60±10.4y) with known CAD were investigated with CACS and MPI within 6 months. CACS was determined using multislice CT. MPI was performed on a triple-headed gamma camera as a 1-day protocol using 99mTc-sestamibi. QPS software package (Cedars-Sinai, Los Angeles, USA) was used to calculate MPI quantitative scores SSS, SRS and SDS. Severe cardiac events (SCE), defined as acute myocardial infarction and cardiac death, as well as soft cardiac events, defined as revascularisation, were registered during follow-up (5.3±2.9 y). Multivariate regression analyses and Kaplan-Meyer curves were applied.

Results: 23 severe and 40 soft events were registered. CACS400 and SRS 2 were identified as independent predictors for SCE (p<0.01) and (p=0.02), while SDS and SSS were associated with the highest revascularisation rates (p=0.001) and (p=0.02). Patients with SSS>8 plus CACS>400 showed the highest risk for SCE (18%, p=0.02), followed by SSS8 plus CACS>400 (10%) and SSS>8 and CACS400 (8%).

Conclusions: In the long term follow up of patients with known CAD, high CACS are associated with an increased risk for SCE after both ischemic and nonischemic MPI studies. Thus, regular calcium scoring may be considered in these patients.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Uebleis, C. Articles by Hacker, M. PubMed Articles by Uebleis, C. Articles by Hacker, M.