ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2012
Assessing risk in acute chest pain: The value of stress myocardial perfusion imaging in patients admitted through the emergency department.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Update of the Brazilian Guideline on Nuclear Cardiology - 2020.Arquivos brasileiros de cardiologia · 2020Guideline
- Regadenoson provides perfusion results comparable to adenosine in heterogeneous patient populations: a quantitative analysis from the ADVANCE MPI trials.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2015Trial
- Stress myocardial perfusion imaging for the evaluation and triage of chest pain in the emergency department: a randomized controlled trial.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2013Trial
- Imaging for chest pain in the emergency room: Finding the right gate not the right gatekeeper.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- ANMCO-SIMEU Consensus Document: in-hospital management of patients presenting with chest pain.European heart journal supplements : journal of the European Society of Cardiology · 2017Article
- Chest pain: coronary CT in the ER.The British journal of radiology · 2016Review
- Use of observation followed by outpatient stress testing in chest pain patients with prior coronary artery disease history: An evaluation of prognostic utility.International journal of cardiology. Heart & vasculature · 2015Article
- ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014Article
- Is regadenoson an appropriate stressor for MPI in patients with left bundle branch block or pacemakers?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2013Article
- Acute chest pain evaluation: is there too much stress on the system?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2013Article
- Acute chest pain of uncertain etiology, the short and long view.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2012Article
- Patient-centered imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2012Article
- Article
- Nuclear cardiology: 2014 innovations and developments.Methodist DeBakey cardiovascular journalReview
- Imaging to Stratify Coronary Artery Disease Risk in Asymptomatic Patients with Diabetes.Methodist DeBakey cardiovascular journalReview
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo prospectively assess the clinical value of stress-gated myocardial single photon emission computed tomography (SPECT) for triaging patients admitted through the emergency department (ED) with acute chest pain (ACP).
methodsProspective, observational cohort study in 1,576 consecutive patients who were evaluated for ACP over a 29-month period. Stress SPECT was performed within 24 hours of admission from the ED. Analysis included quantification of total and ischemic left ventricular perfusion defect size (PDS). Cardiac events were defined as an acute coronary syndrome during the index hospitalization or in follow-up over 7.3 ± 2.8 months.
resultsEighty-five cardiac events occurred in 77 patients (4.9%). SPECT was abnormal in 135 patients (8.6%) of whom 83 (61.5%) had a reversible defect. Event rates were significantly higher in patients with an abnormal (40%) versus a normal (1.6%) SPECT (P < .0001); and in those with a (1) large (>15%) versus small (≤15%) PDS (50.0% vs 33.7%, P = .05) and (2) large (>10%) versus small (≤10%) ischemic PDS (87.5% vs 42.4%, P < .0001, respectively). SPECT best predicted cardiac events by multivariate analysis. The addition of SPECT to clinical variables significantly improved overall risk prediction (global χ(2) 103.6 vs 207.1, P < .001).
conclusionsStress SPECT can accurately assess risk in a heterogeneous group of patients with ACP of unclear cardiac etiology, and beyond that provided by a clinical risk assessment alone. Our results support the use of stress SPECT for identifying very low-risk ACP patients with normal study results who can be safely discharged home.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.