ArticleEuropean journal of nuclear medicine and molecular imaging2014
Myocardial perfusion imaging in stable symptomatic patients with extensive coronary atherosclerosis.
Article in European journal of nuclear medicine and molecular imaging, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Coronary calcium score influences referral for invasive coronary angiography after normal myocardial perfusion SPECT.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Coronary artery calcium score as a gatekeeper in the non-invasive evaluation of suspected coronary artery disease in symptomatic patients.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
- Sequential SPECT/CT imaging starting with stress SPECT in patients with left bundle branch block suspected for coronary artery disease.European radiology · 2017Article
- Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease.Arquivos brasileiros de cardiologia · 2016Review
- Prognostic significance of calcified plaque among symptomatic patients with nonobstructive coronary artery disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014Observational
- Prevalence, location, and extent of significant coronary artery disease in patients with normal myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014Article
- Clinical usefulness of novel serum and imaging biomarkers in risk stratification of patients with stable angina.Disease markers · 2014Review
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Authors and funding
7 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeHigh coronary artery calcium (CAC) scores are associated with a high likelihood of ischaemia and obstructive coronary disease. Myocardial perfusion imaging (MPI) is a key investigation to determine the need for revascularization. However, the value of MPI in presence of extensive CAC has so far only been demonstrated in asymptomatic patients, whereas its value in symptomatic patients remains largely unclear. Therefore, we studied the impact of MPI in symptomatic patients with a CAC score ≥ 1,000.
methodsWe included 282 patients (mean age 69 ± 9 years, 63% men) without a history of coronary disease with suspected stable angina referred for MPI and with a CAC score ≥ 1,000. On follow-up at 18 months invasive angiography, coronary revascularization, nonfatal myocardial infarction and death were recorded.
resultsMPI was normal in 54 %, equivocal in 10 % and abnormal in 37 % (fixed defect 9 % and ischaemia 28 %) of patients. More abnormal MPI findings were observed in men, smokers and those with even higher CAC scores. During follow-up, 1 patient (with nonischaemic MPI) died from a cardiac cause, 1 patient (with ischaemic MPI) suffered a myocardial infarction and 92 patients (33 %) underwent revascularization. Ischaemia on MPI was a strong predictor of coronary revascularization (odds ratio 13.1; 95 % CI 7.1-24.3; p < 0.001).
conclusionIschaemia on MPI is observed in approximately 30 % of patients with a CAC score ≥ 1,000, and is a strong predictor of coronary revascularization. However, nonischaemic MPI does not exclude revascularization, and patients with persisting complaints should be considered for invasive angiography.
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