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Title: Prognostic value of myocardial perfusion SPECT images in combination with the maximal heart rate at exercise testing in Japanese patients with suspected ischemic heart disease: A sub-analysis of J-ACCESS
Authors: Ueshima, Kenji  kyouindb  KAKEN_id
Yamashina, Akira
Usami, Satoru
Yasuno, Shinji  kyouindb  KAKEN_id
Nishiyama, Osamu
Yamazaki, Takuya
Nakao, Kazuwa
Nishimura, Tsunehiko
Author's alias: 上嶋, 健治
Keywords: Cardiac events
Exercise test
J-ACCESS
SPECT
Issue Date: Dec-2009
Publisher: Springer Verlag
Journal title: Annals of Nuclear Medicine
Volume: 23
Issue: 10
Start page: 849
End page: 854
Abstract: Objectives We assessed whether a combination of summed stress scores (SSS) using exercise myocardial perfusion SPECT (Ex-SPECT) and maximal heart rate accurately predicts cardiac events through a sub-analysis of J-ACCESS (Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT) which was conducted to evaluate the prognosis of Japanese patients with suspected ischemic heart disease. Methods In J-ACCESS, 2, 373 patients with suspected coronary artery disease not receiving beta-blocker treatment underwent Ex-SPECT. These patients were categorized into the following four groups: Group A [achieved target heart rate (THR) and SSS < 4: n = 631], B (did not achieve THR and SSS < 4: n = 612), C (achieved THR and SSS ≥ 4: n = 570), and D (did not achieve THR and SSS ≥ 4: n = 560). We evaluated the incidence rate of cardiac events including cardiac death, myocardial infarction, and heart failure requiring hospital admission during a 3-year period. Results In Group A, B, C, and D, 9 of 631 (1.4%), 15 of 612 (2.4%), 23 of 570 (4.0%) and 30 of 560 (5.4%) patients experienced cardiac events, respectively. Although the hazard ratio of the SSS ≥ 4 was 2.45 (p < 0.001) and that of the attained THR was 0.69 (p = 0.10) in the multiple Cox regression analysis, Kaplan–Meier curves showed that the cardiac events rate was lower in the order of A, B, C, and D (p < 0.001). Conclusion The combination of SSS using Ex-SPECT and the maximal heart rate is a useful predictor of cardiac events in patients with suspected coronary artery disease.
Rights: c 2009 The Japanese Society of Nuclear Medicine.
この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。This is not the published version. Please cite only the published version.
URI: http://hdl.handle.net/2433/91267
DOI(Published Version): 10.1007/s12149-009-0315-8
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