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Prognostic value of stress 99mTc-tetrofosmin myocardial perfusion imaging in predicting all-cause mortality: a 6-year follow-up study

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to ascertain whether stress myocardial perfusion imaging can independently predict long-term mortality.

Methods

We studied 1,386 patients with known or suspected coronary artery disease by means of stress 99mTc-tetrofosmin myocardial perfusion tomography. The end point during follow-up was death from any cause. Mortality rates were compared with that in a reference population using calculated age- and gender-specific data in the general population.

Results

Mean age was 60±11 years. There were 608 (44%) women. Perfusion abnormalities were fixed in 416 (30%) patients and reversible in 445 (32%) patients. During a mean follow-up of 6±1.9 years, 290 (21%) patients died. The annual mortality was 1.7% in patients with normal perfusion and 5.2% in patients with abnormal perfusion. Patients with multivessel distribution of perfusion abnormalities had the highest annual mortality (6.2%). The annual mortality in the reference population was 3.2%. In a multivariate analysis model, predictors of death were age [risk ratio (RR)=1.06, 95% CI 1.04–1.07], male gender (RR=2, CI 1.6–2.6), history of heart failure (RR=2.3, CI 1.8–3.1), diabetes mellitus (RR=2.1, CI 1.6–2.7), smoking (RR=1.8, CI 1.4–2.3), reversible perfusion defects (RR=1.8, CI 1.4–2.5) and fixed perfusion defects (RR=1.7, CI 1.3–2.1).

Conclusion

Myocardial perfusion abnormalities on stress 99mTc-tetrofosmin tomography are independently associated with long-term risk of death. The extent of perfusion abnormalities is a major determinant of mortality. The presence of normal perfusion is associated with a lower mortality compared with the general population.

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Acknowledgement

This study was supported in part with a publication grant from GE Health Care.

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Authors and Affiliations

  1. Thoraxcenter, Department of Cardiology, University Hospital Dijkzigt, Rotterdam, The Netherlands

    Abdou Elhendy, Arend F. L. Schinkel, Ron T. van Domburg, Elena Biagini & Don Poldermans

  2. University of Nebraska Medical Center, Omaha, NE, USA

    Abdou Elhendy

  3. Department of Cardiology, University Hospital Leiden, Leiden, The Netherlands

    Jeroen J. Bax

  4. Department of Nuclear Medicine, University Hospital Dijkzigt, Rotterdam, The Netherlands

    Roelf Valkema

Authors
  1. Abdou Elhendy
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  2. Arend F. L. Schinkel
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  3. Ron T. van Domburg
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  4. Jeroen J. Bax
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  5. Roelf Valkema
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  6. Elena Biagini
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  7. Don Poldermans
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Correspondence to Abdou Elhendy.

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Elhendy, A., Schinkel, A.F.L., van Domburg, R.T. et al. Prognostic value of stress 99mTc-tetrofosmin myocardial perfusion imaging in predicting all-cause mortality: a 6-year follow-up study. Eur J Nucl Med Mol Imaging 33, 1157–1161 (2006). https://doi.org/10.1007/s00259-006-0140-4

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  • DOI: https://doi.org/10.1007/s00259-006-0140-4

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