ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2010
The prognosis of a normal stress-only Tc-99m myocardial perfusion imaging study.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers.
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Who cites it
61 citing papers in PubMed, 112 citations in OpenAlex.
- Integrating perfusion with AI-derived coronary calcium on CT attenuation scans to improve selection of low-risk studies for stress-only SPECT myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2025Article
- ECHO-MPS, a dual modality strategy of cardiac imaging to identify myocardial ischemia.The international journal of cardiovascular imaging · 2024Article
- Incremental Value of Exercise ECG to Myocardial Perfusion Single-Photon Emission Computed Tomography for Prediction of Cardiac Events.Journal of the American Heart Association · 2023Article
- The chest pain guidelines revisited: cherry picking from the frequentist tree.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Prognostically safe stress-only single-photon emission computed tomography myocardial perfusion imaging guided by machine learning: report from REFINE SPECT.European heart journal. Cardiovascular Imaging · 2021Article
- What is the optimal activity ratio for same-day myocardial perfusion SPECT?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Diagnosis and Prognosis of Coronary Artery Disease with SPECT and PET.Current cardiology reports · 2019Review
- Simplified approach to stress-first nuclear myocardial perfusion imaging: implementation of Choosing Wisely recommendations.BMJ open quality · 2019Article
- Single Photon Emission Computed Tomography (SPECT) Myocardial Perfusion Imaging Guidelines: Instrumentation, Acquisition, Processing, and Interpretation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Review
- Choosing patients for stress-first/stress-only imaging: Keep it simple.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Triage of patients for attenuation-corrected stress-first Tc-99m SPECT MPI using a simplified clinical pre-test scoring model.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Prognosis of stress-only SPECT myocardial perfusion imaging with prone imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Time to get on the stress-only bandwagon?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Prognostic value of one millisievert exercise myocardial perfusion imaging in patients without known coronary artery disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Myocardial perfusion imaging in women for the evaluation of stable ischemic heart disease-state-of-the-evidence and clinical recommendations.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- Implementation of stress-only imaging: What will it take?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- Multicenter evaluation of stress-first myocardial perfusion image triage by nuclear technologists and automated quantification.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- A world view of nuclear cardiology practices: Think globally, act locally.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- Sequential SPECT/CT imaging for detection of coronary artery disease in a large cohort: evaluation of the need for additional imaging and radiation exposure.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- Stress-first single photon emission computed myocardial perfusion imaging.Translational medicine @ UniSa · 2016Article
1 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStress-only imaging saves time and radiation exposure, but apprehension remains about the reliability, diagnostic, and prognostic accuracy of a normal stress-only study. The objective of this study was to determine the prognosis of stress-only SPECT MPI in routine clinical practice.
methodsPatients at lower pre-test risk for CAD presenting for a Tc-99m SPECT MPI over a 2-year period underwent a stress-only protocol. If the stress images were normal (attenuation correction was routinely acquired on all patients), rest imaging was not done. Outcomes of the stress-only group were compared to a full rest-stress protocol cohort. Only patients with normal perfusion and left ventricular function, and no known CAD, were included. All-cause mortality was determined using the Social Security Death Index and specific causes of death were determined using the National Death Index. The difference in all-cause and cardiac mortality between groups in the presence of competing risks was assessed using log-normal survival models.
resultsOut of 10,609 patients studied during the time period, 1,673 had a normal stress-only study and 3,237 had a normal rest-stress study. At one year, there were 20 total and 3 cardiac deaths (1.2% and 0.2% mortality) in the stress-only group, and 40 total and 4 cardiac deaths (1.2% and 0.1% mortality) in the rest-stress cohort. At the end of follow-up (40 +/- 9 months), there were 46 total and 7 cardiac deaths (2.7% and 0.4% mortality) in the stress-only group, and 119 total and 17 cardiac deaths (3.7% and 0.5% mortality) in the rest-stress cohort. No significant difference between the stress-only and rest-stress cohorts was found after controlling for confounding variables for both all-cause mortality (p = .94) and cardiac mortality (p = .82).
conclusionsA normal stress-only MPI has an excellent short-term prognosis (both for all-cause and cardiac mortality) comparable to that of a normal rest-stress MPI study.
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