Usefulness of Stress Myocardial Perfusion Imaging for Evaluating Asymptomatic Patients After Coronary Stent Implantation

元データ 2004-04-20

概要

Background Stent implantation in coronary angioplasty has reduced the rate of restenosis, but many patients still undergo follow-up coronary angiography (CAG). The present study was a multi-center retrospective analysis of the usefulness of stress single photon emission computed tomography (SPECT) compared with follow-up CAG in stent-implanted patients who remained asymptomatic during the follow-up period. Methods and Results The study group of 103 patients underwent both SPECT and CAG at 4-9 months after stent implantation. Restenosis occurred in 20 (19%) of 106 vessel territories, and a reversible perfusion defect was found in 32 (30%) territories. Sensitivity, specificity, positive and negative predictive values, and accuracy of SPECT were 65%, 78%, 41%, 91%, and 76%, respectively. The accuracy was lower in territories with a prior myocardial infarction (71%), in the left circumflex artery (58%), and in cases with three-vessel disease (63%). The negative predictive value was high, but 7 false negative cases included 4 cases with prior myocardial infarction, and 2 cases with reversible defects in other vessel territories. Conclusions Stress SPECT imaging is a useful tool for following up patients with coronary stent implantation, and follow-up CAG could be omitted in patients with negative SPECT imaging, no prior myocardial infarction, one- or two-vessel disease, and sufficient stress loading.

著者

Satoh Hiroshi Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
KATOH Hideki Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
HAYASHI Hideharu Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
Chin Ka Third Department of Internal Medicine
Katoh Hideki Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
Hayashi Hideharu Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
Hayashi Hideharu Department Of Internal Medicine Iii Hamamatsu University School Of Medicine
KURATA Chinori YAMAHA Health Care Center
Suzuki Shingo Iwata City Hospital
Yoshihara Shu Internal Medicine Iii Hamamatsu University School Of Medicine
Terada Hajime Divisions Of Cardiology Department Of Internal Medicine Iii
Terada Hajime Department Of Medicine Iii Hamamatsu University Of Medicine
Kurata C Yamaha Health Care Center
Kurata Chinori Hamamatsu University School Of Medicine
Tawarahara Kei Department Of Cardiology Hamamatsu Red Cross Hospital
Tawarahara Kei The Third Department Of Internal Medicine Hamamatsu University School Of Medicine
Matsunaga Masaki Department Of Internal Medicine Iii Hamamatsu University School Of Medicine
Suzuki Shingo Hamamatsu Circulation Forum
Tawarahara Kei Hamamatsu Circulation Forum
Sugiyama Tsuyoshi Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
Uehara Akihiko Divisions Of Cardiology Department Of Internal Medicine Iii
Uehara Akihiko Department Of Internal Medicine Iii Hamamatsu University School Of Medicine
Matsunaga Masaki Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
Nakano Tomoyasu Department Of Internal Medicine 3 Hamamatsu University School Of Medicine
Matoh Fumitaka Department Of Emergency Medicine Hamamatsu University School Of Medicine
Machii Masashi Department Of Internal Medicine Iii Hamamatsu University School Of Medicine
Yamazaki Keisuke Divisions of Cardiology, Department of Internal Medicine III
Ukigai Hiroshi Hamamatsu Red-cross hospital
Nakano Tomoyasu 3rd Department Of Internal Medicine Hamamatsu University
Yoshihara Shu Division of Cardiology, Internal Medicine 3, Hamamatsu University School of Medicine
Sone Hirohito Department Of Nutrition Ochanomizu University
Tawarahara Kei Hamamatsu Red Cross Hospital
Miyata Haruo Seirei Mikatahara Hospital
Miyata Haruo Seirei Mikatahara General Hospital
Kurata Chinori Department Of Medicine Iii Hamamatsu University School Of Medicine
Sugi Toshihiko Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
Matoh Fumitaka Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
Nakano Tomoyasu Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
Kimura Masahiko Fujinomiya City Hospital
Terada Hajime Third Department Of Internal Medicine Hamamatsu University School Of Medicine
Yamazaki Keisuke Divisions Of Cardiology Department Of Internal Medicine Iii
Kurata Chinori The Third Department Of Internal Medicine Hamamatsu University School Of Medicine
Nakano Tomoyasu Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
Nakano Tomoyasu Department Of Internal Medicine Iii Hamamatsu University School Of Medicine
Uehara Akihiro 3rd Department Of Internal Medicine Hamamatsu University

関連論文

▼もっと見る