Thursday, November 20, 2014

Long-term mortality after a normal nuclear SPECT exam

Long-term mortality following normal exercise myocardial perfusion SPECT according to coronary disease risk factors.
QUESTION: does a normal SPECT study carry the same prognosis among different patient sub-groups according to risk factors?

METHODS: 12,232 patients with a normal exercise SPECT-MPI scan were evaluated.

RESULTS: The all cause morality rate overall was 0.8%/year, but varied according the the presence of risk factors. Hypertension, smoking, diabetes, exercise capacity, dyspnea, obesity, higher resting heart rate, an abnormal ECG, LVH, atrial fibrillation, and LVEF < 45% were all predictors of increased mortality.

ALL CAUSE MORTALITY RATES
  • 0.2% per year among non-smokers exercising for >9 minutes with no hypertension or diabetes
  • 1.6% per year among patients exercising <6 minutes at least 2 of the following: hypertension, diabetes, or smoking.

CONCLUSIONS: Mortality risk varies with comorbidities and is not exclusively dependent upon nuclear SPECT imaging results. 

J Nucl Cardiol. 2014 Apr;21(2):341-50

COMMENT: isn't it great that we are able to modify at least one of the primary risk factors (smoking)?