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. 2021 Dec;28(6):2799-2807.
doi: 10.1007/s12350-020-02135-y. Epub 2020 May 7.

The prognostic value of regadenoson SPECT myocardial perfusion imaging: The largest cohort to date

Ajoe John Kattoor  1 , Ahmed A Kolkailah  2 , Fady Iskander  1 , Mina Iskander  1 , Lisa Diep  3 , Rozi Khan  4   5 , Rami Doukky  6   7   8
Affiliations

The prognostic value of regadenoson SPECT myocardial perfusion imaging: The largest cohort to date

Ajoe John Kattoor et al. J Nucl Cardiol. 2021 Dec.

Abstract

Background: Data on the prognostic value of regadenoson SPECT myocardial perfusion imaging (MPI) is limited and based on small cohorts.

Methods and results: We conducted a single-center, retrospective cohort study of 10,275 consecutive patients who underwent regadenoson SPECT-MPI. Among the study subjects, 28.7% had abnormal MPI and 25.5% had myocardial ischemia. Patients were followed for a mean of 2.4 ± 2.2 years for major adverse cardiac events (MACE), defined as cardiac death or myocardial infarction. There was a significant stepwise increase in MACE with an increasing burden of perfusion abnormality (P < .001) and myocardial ischemia (P < .001). Abnormal MPI (adjusted HR 1.52; 95% CI 1.21 to 1.91) and myocardial ischemia (adjusted HR 1.53; 95% CI 1.25 to 1.89) were associated with MACE, independent of and incremental to clinical covariates and left ventricular ejection fraction (LVEF). Moreover, post-stress LVEF, LVEF reserve, and left ventricular end-diastolic volume added significant prognostic information. Transient ischemic dilation ≥ 1.31 did not provide incremental prognostic value (adjusted HR 1.02; P = .906).

Conclusion: In the largest cohort to date, we demonstrated that the presence and severity of perfusion abnormality and myocardial ischemia on regadenoson stress SPECT-MPI are associated with an independent increase in MACE.

Keywords: Prognosis; SPECT; myocardial perfusion imaging (MPI); outcome; regadenoson.

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