Skip to main content
Log in

Prognostic table for predicting major cardiac events based on J-ACCESS investigation

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

The event risk of patients with coronary heart disease may be estimated by a large-scale prognostic database in a Japanese population. The aim of this study was to create a heart risk table for predicting the major cardiac event rate.

Methods

Using the J-ACCESS database created by a prognostic investigation involving 117 hospitals and >4000 patients in Japan, multivariate logistic regression analysis was performed. The major event rate over a 3-year period that included cardiac death, non-fatal myocardial infarction, and severe heart failure requiring hospitalization was predicted by the logistic regression equation. The algorithm for calculating the event rate was simplified for creating tables.

Results

Two tables were created to calculate cardiac risk by age, perfusion score category, and ejection fraction with and without the presence of diabetes. A relative risk table comparing age-matched control subjects was also made. When the simplified tables were compared with the results from the original logistic regression analysis, both risk values and relative risks agreed well (P < 0.0001 for both).

Conclusions

The Heart Risk Table was created for patients suspected of having ischemic heart disease and who underwent myocardial perfusion gated single-photon emission computed tomography. The validity of risk assessment using a J-ACCESS database should be validated in a future study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Klocke FJ, Baird MG, Lorell BH, Bateman TM, Messer JV, Berman DS, et al. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging). Circulation 2003;108:1404–1418.

    Article  PubMed  Google Scholar 

  2. Tamaki N. Guidelines for clinical use of cardiac nuclear medicine (JCS 2005). Circulation J 2005;69:1125–1202.

    Google Scholar 

  3. Kusuoka H, Nishimxura S, Yamashina A, Nakajima K, Nishimura T. Surveillance study for creating the national clinical database related to ECG-gated myocardial perfusion SPECT of ischemic heart disease: J-ACCESS study design. Ann Nucl Med 2006;20:195–202.

    Article  PubMed  Google Scholar 

  4. Nakajima K, Nishimura T. Inter-institution preference-based variability of ejection fraction and volumes using quantitative gated SPECT with 99mTc-tetrofosmin: a multicentre study involving 106 hospitals. Eur J Nucl Med Mol Imaging 2006;33:127–133.

    Article  PubMed  Google Scholar 

  5. Nakajima K, Kusuoka H, Nishimura S, Yamashina A, Nishimura T. Normal limits of ejection fraction and volumes determined by gated SPECT in clinically normal patients without cardiac events: a study based on the J-ACCESS database. Eur J Nucl Med Mol Imaging 2007;34:1088–1096.

    Article  PubMed  Google Scholar 

  6. Nishimura T, Nakajima K, Kusuoka H, Yamashina A, Nishimura S. Prognostic study of risk stratification among Japanese patients with ischemic heart disease using gated myocardial perfusion SPECT: J-ACCESS study. Eur J Nucl Med Mol Imaging 2007;35:319–328.

    Article  PubMed  Google Scholar 

  7. Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation 2003;107:2900–2907.

    Article  PubMed  Google Scholar 

  8. Berman DS, Abidov A, Kang X, Hayes SW, Friedman JD, Sciammarella MG, et al. Prognostic validation of a 17-segment score derived from a 20-segment score for myocardial perfusion SPECT interpretation. J Nucl Cardiol 2004;11:414–423.

    Article  PubMed  Google Scholar 

  9. Hachamovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Cabico JA, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation 1998;97:535–543.

    PubMed  CAS  Google Scholar 

  10. Sharir T, Germano G, Kavanagh PB, Lai S, Cohen I, Lewin HC, et al. Incremental prognostic value of post-stress left ventricular ejection fraction and volume by gated myocardial perfusion single photon emission computed tomography. Circulation 1999;100:1035–1042.

    PubMed  CAS  Google Scholar 

  11. Germano G, Kiat H, Kavanagh PB, Moriel M, Mazzanti M, Su HT, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med 1995;36:2138–2147.

    PubMed  CAS  Google Scholar 

  12. Nishimura T. Software using J-ACCESS clinical database: Heart Risk View (user manual) version 1 (in Japanese). Tokyo: Nihon Medi Physics; 2007.

    Google Scholar 

  13. Petix NR, Sestini S, Coppola A, Marcucci G, Nassi F, Taiti A, et al. Prognostic value of combined perfusion and function by stress technetium-99m sestamibi gated SPECT myocardial perfusion imaging in patients with suspected or known coronary artery disease. Am J Cardiol 2005;95:1351–1357.

    Article  PubMed  Google Scholar 

  14. Berman DS, Kang X, Hayes SW, Friedman JD, Cohen I, Abidov A, et al. Adenosine myocardial perfusion single-photon emission computed tomography in women compared with men: impact of diabetes mellitus on incremental prognostic value and effect on patient management. J Am Coll Cardiol 2003;41:1125–1133.

    Article  PubMed  Google Scholar 

  15. Matsuo S, Nakajima K, Horie M, Nakae I, Nishimura T. Prognostic value of normal stress myocardial perfusion imaging in Japanese population. Circ J 2008;72:611–617.

    Article  PubMed  Google Scholar 

  16. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998;339:229–234.

    Article  PubMed  CAS  Google Scholar 

  17. Wackers FJ, Young LH, Inzucchi SE, Chyun DA, Davey JA, Barrett EJ, et al. Detection of silent myocardial ischemia in asymptomatic diabetic subjects: the DIAD study. Diabetes Care 2004;27:1954–1961.

    Article  PubMed  Google Scholar 

  18. Nishimura T, Nakajima K, Tsukamoto K. Estimation of cardiac event rate by myocardial SPECT based on Japanese EBM: development of Heart Risk View software (in Japanese). Eizo Joho Med 2008;40:430–435.

    Google Scholar 

  19. Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. A prognostic score for prediction of cardiac mortality risk after adenosine stress myocardial perfusion scintigraphy. J Am Coll Cardiol 2005;45:722–729.

    Article  PubMed  Google Scholar 

  20. Iskandrian AS, Chae SC, Heo J, Stanberry CD, Wasserleben V, Cave V. Independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in coronary artery disease. J Am Coll Cardiol 1993;22:665–670.

    Article  PubMed  CAS  Google Scholar 

  21. Grundy SM, Pasternak R, Greenland P, Smith S Jr, Fuster V. Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology. Circulation 1999;100:1481–1492.

    PubMed  CAS  Google Scholar 

  22. Bateman T. Clinical relevance of a normal myocardial perfusion scintigraphic study. J Nucl Cardiol 1998;4:172–173.

    Article  Google Scholar 

  23. Kusuoka H, Yamasaki Y, Izumi T, Kashiwagi A, Kawamori R, Shimamoto K, et al. Surveillance study for creating the national clinical database relating to ECG-gated myocardial perfusion SPECT of asymptomatic ischemic heart disease in patients with type-2 diabetes mellitus: J-ACCESS 2 study design. Ann Nucl Med 2008;22:13–21.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kenichi Nakajima.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakajima, K., Nishimura, T. Prognostic table for predicting major cardiac events based on J-ACCESS investigation. Ann Nucl Med 22, 891–897 (2008). https://doi.org/10.1007/s12149-008-0189-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-008-0189-1

Keywords

Navigation