ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2016
Predictors of high-risk coronary artery disease in subjects with normal SPECT myocardial perfusion imaging.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed.
- Sensitivity and predictors of false-negative SPECT myocardial perfusion imaging in a high-burden coronary artery disease population: a retrospective analysis using revascularization as the reference standard.BMC cardiovascular disorders · 2026Article
- Analysis and Characterization of Factors Affecting the Consistency of Tl-201 Myocardial Perfusion Single-Photon Emission Computed Tomography and Coronary Angiography Results in Patients with Suspected Coronary Artery Disease.Diagnostics (Basel, Switzerland) · 2025Article
- Effect of patent complete revascularization on myocardium with persistent perfusion defects in preoperative single-photon emission computed tomography.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Emerging Applications of Positron Emission Tomography in Coronary Artery Disease.Journal of personalized medicine · 2025Review
- Multivessel Coronary Artery Disease Presenting as a False-Negative Nuclear Stress Test: A Case of Balanced Ischemia.Cureus · 2024Article
- Cardiac Magnetic Resonance Imaging in Heart Failure.Cardiovascular innovations and applications · 2024Article
- Improved Performance of PET Myocardial Perfusion Imaging Compared to SPECT in the Evaluation of Suspected CAD.Current cardiology reports · 2023Review
- Negative Stress Test Is Not Always Negative: Revisiting the Clinical Implications of Balanced Ischemia.Cureus · 2022Article
- Gated SPECT beyond myocardial perfusion: assessment of mechanical left ventricular synchrony.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Nuclear Cardiology in Women and Underrepresented Minority Populations.Current cardiology reports · 2022Review
- Diagnostic accuracy of stress-only myocardial perfusion SPECT improved by deep learning.European journal of nuclear medicine and molecular imaging · 2021Article
- Early onset of left ventricular regional asynchrony in arteries with sub-clinical stenosis.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- The magic of improved crystal technology coupled with better resolution: Novel imaging findings may promise improved disease detection.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Left ventricular dyssynchrony and abnormalities in wall motion, assessed by gated-SPECT as ischemic auxiliary markers.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Observational
- Auxiliary ischemic markers, the role of left ventricular dyssynchrony.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
- Non ECG gated supine to prone left ventricular volume ratio: a novel marker for myocardial ischemia.The international journal of cardiovascular imaging · 2020Article
- Feasibility and accuracy of SPECT myocardial perfusion imaging in end-stage lung disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
- My warranty has expired: I need to be retested.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Diagnosis and Prognosis of Coronary Artery Disease with SPECT and PET.Current cardiology reports · 2019Review
- Prognostic value of left ventricular dyssynchrony evaluated by gated myocardial perfusion imaging in patients with chronic kidney disease and normal perfusion defect scores.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
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Abstract
backgroundWhile uncommon, normal stress SPECT myocardial perfusion imaging (MPI) can be seen in patients with high-risk coronary artery disease (CAD) by invasive coronary angiography (ICA).The predictors of high-risk CAD in patients with normal SPECT-MPI have not been described.
methodsWe studied 580 patients (age 64 ± 12 years, 49% men) without known CAD who underwent stress-gated SPECT-MPI [exercise (41%) or vasodilator (59%)] <2 months before ICA and had summed stress score (SSS) <4. High-risk CAD was defined as 3 vessels with ≥70% stenosis, 2 vessels with ≥70% stenosis including proximal left anterior descending, or left main with ≥50% stenosis. Obstructive non-high-risk CAD was defined by the presence of a ≥70% stenosis but without having other high-risk criteria. Tenfold cross-validated receiver operating characteristic (ROC) estimates were obtained to assess the predictors of high-risk CAD.
resultsForty-two subjects (7.2%) had high-risk CAD and 168 (29.0%) had obstructive non-high-risk CAD. Variables associated with high-risk CAD were pretest probability of CAD ≥66% (Odds ratio [OR] 3.63, 95% CI 1.6-8.3, P = .002), SSS > 0 (OR 7.46, 95% CI 2.6-21.1, P < 0.001), and abnormal TID (OR 2.16, 95% CI 1.0-4.5, P = 0.044). When substituted for TID, EF change was also predictive of high-risk CAD (OR 0.93, 95% CI 0.9-1.0, P = 0.023). The prevalence of high-risk CAD increased as the number of these predictors increased. In a sub-analysis of patients in whom quantitative total perfusion deficit (TPD) was available, TPD > 0 was also a predictor of high-risk CAD (OR 6.01, 95% CI 1.5-22.2, P = 0.011).
conclusionSeveral clinical, stress, and SPECT-MPI findings are associated high-risk CAD among patients with normal SPECT-MPI. Consideration of these factors may improve the overall assessment of the likelihood of high-risk CAD in patients undergoing stress SPECT-MPI.
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