Journal of Nuclear Cardiology

, Volume 17, Issue 2, pp 188–196 | Cite as

Diagnostic and clinical benefit of combined coronary calcium and perfusion assessment in patients undergoing PET/CT myocardial perfusion stress imaging

  • Kevin A. Bybee
  • John Lee
  • Richard Markiewicz
  • Ryan Longmore
  • A. Iain McGhie
  • James H. O’Keefe
  • Bai-Ling Hsu
  • Kevin Kennedy
  • Randall C. Thompson
  • Timothy M. Bateman
Original Article

Abstract

Background

A limitation of stress myocardial perfusion imaging (MPI) is the inability to detect non-obstructive coronary artery disease (CAD). One advantage of MPI with a hybrid CT device is the ability to obtain same-setting measurement of the coronary artery calcium score (CACS).

Methods and Results

Utilizing our single-center nuclear database, we identified 760 consecutive patients with: (1) no CAD history; (2) a normal clinically indicated Rb-82 PET/CT stress perfusion study; and (3) a same-setting CAC scan. 487 of 760 patients (64.1%) had subclinical CAD based on an abnormal CACS. Of those with CAC, the CACS was >100, >400, and >1000 in 47.0%, 22.4%, and 8.4% of patients, respectively. Less than half of the patients with CAC were receiving aspirin or statin medications prior to PET/CT imaging. Patients with CAC were more likely to be initiated or optimized on proven medical therapy for CAD immediately following PET/CT MPI compared to those without CAC.

Conclusions

Subclinical CAD is common in patients without known CAD and normal myocardial perfusion assessed by hybrid PET/CT imaging. Identification of CAC influences subsequent physician prescribing patterns such that those with CAC are more likely to be treated with proven medical therapy for the treatment of CAD.

Keywords

PET/CT imaging atherosclerosis coronary artery disease diagnostic and prognostic application myocardial perfusion imaging: PET 

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Copyright information

© American Society of Nuclear Cardiology 2009

Authors and Affiliations

  • Kevin A. Bybee
    • 1
    • 2
    • 3
  • John Lee
    • 1
    • 3
  • Richard Markiewicz
    • 1
  • Ryan Longmore
    • 1
  • A. Iain McGhie
    • 1
    • 2
    • 3
  • James H. O’Keefe
    • 1
    • 2
    • 3
  • Bai-Ling Hsu
    • 4
  • Kevin Kennedy
    • 3
  • Randall C. Thompson
    • 1
    • 2
    • 3
  • Timothy M. Bateman
    • 1
    • 2
    • 3
    • 4
  1. 1.University of Missouri-Kansas City School of MedicineKansas CityUSA
  2. 2.Cardiovascular Consultants, PAOverland ParkUSA
  3. 3.St. Luke’s Mid-America Heart InstituteKansas CityUSA
  4. 4.Cardiovascular Imaging TechnologiesKansas CityUSA

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