Prognostic Value of Coronary Artery Calcium Scoring in Addition to Single-Photon Emission Computed Tomographic Myocardial Perfusion Imaging in Symptomatic Patients
Prognostic Value of Coronary Artery Calcium Scoring in Addition to Single-Photon Emission Computed Tomographic Myocardial Perfusion Imaging in Symptomatic Patients
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DOI：
10.1161/circimaging.115.003966
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发表时间：
2016-05-01
影响因子：
7.5
通讯作者：
Jager, Pieter L.
中科院分区：
文献类型：
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作者：
Engbers, Elsemiek M.;Timmer, Jorik R.;Jager, Pieter L.
背景-冠状动脉钙（CAC）评分的心肌灌注显像与单光子发射计算机断层扫描（SPECT）在疑似冠心病患者的预后价值还没有很好地建立起来。方法和结果-四千八百九十七名无冠状动脉疾病史的症状患者被纳入SPECT和CAC评分。主要不良心脏事件（MACE）定义为晚期血运重建（扫描后>90天）、非致命性心肌梗死和全因死亡。SPECT异常的频率随着CAC评分的升高而增加，CAC评分为0的患者为12%，CAC评分为1 - 99、100 - 399、400 - 999和>= 1000的患者分别为19%、32%、37%和50（P= 1000：5.5%）和SPECT异常（年事件率CAC评分0：0.4%; CAC评分≥ 1000：7.6%）。多因素分析后，SPECT和CAC评分均为MACE的独立预测因素（CAC评分>= 1000：风险比，7.7; P
Background-The prognostic value of coronary artery calcium (CAC) scoring on top of myocardial perfusion imaging with single-photon emission computed tomography (SPECT) in patients suspected for coronary artery disease is not well established.Methods and Results-Four thousand eight hundred ninety-seven symptomatic patients without a history of coronary artery disease referred for SPECT and CAC scoring were included. Major adverse cardiac events (MACEs) were defined as late revascularization (>90 days after scanning), nonfatal myocardial infarction, and all-cause mortality. The frequency of abnormal SPECT increased with higher CAC scores, from 12% in patients with CAC scores of 0 to 19%, 32%, 37%, and 50% among those with CAC scores 1 to 99, 100 to 399, 400 to 999, and >= 1000, respectively (P= 1000: 5.5%) and abnormal SPECT (annual event rate CAC score 0: 0.4%; CAC score >= 1000: 7.6%). After multivariate analysis, both SPECT and CAC score were independent predictors of MACE (CAC score >= 1000: hazard ratio, 7.7; P