Quantitative Gated Single-Photon Emission Computed Tomography With ^<99m>Tc Sestamibi Predicts Major Cardiac Events in Elderly Patients With Known or Suspected Coronary Artery Disease : The QGS-Prognostic Value in the Elderly(Q-PROVE) Study

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概要

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• Background Although electrocardiogram-gated single-photon emission computed tomography (SPECT) may be useful in risk stratification of elderly patients with coronary artery disease (CAD), few studies have prospectively evaluated its prognostic value in this patient population. Methods and Results A total of 175 patients aged 75 years or more with known or suspected CAD were prospectively evaluated by stress gated SPECT using a 20-segment model and an automatic functional analysis. Patients with acute coronary syndrome within the previous 3 months, and those who underwent coronary revascularization within 3 months after the SPECT study were excluded. Outcome assessment included prespecified cardiac events and noncardiac deaths. During a mean follow-up of 3.4 years, there were 18 cardiac events: 2 cardiac deaths, 1 nonfatal myocardial infarction, 3 coronary artery bypass grafting, 5 percutaneous coronary interventions, 1 unstable angina, 4 heart failures, and 2 malignant arrhythmias. Kaplan-Meier survival estimation indicated an event-free survival rate of 98.1% at 3 years in patients without myocardial ischemia, but 79.9% in those with ischemia as documented by gated SPECT (p=0.0001). Multivariate analysis using the Cox proportional hazard model demonstrated that stress-induced myocardial ischemia was the only independent predictor for subsequent cardiac events (p<0.01). Conclusions Stress gated SPECT predicts cardiac events in patients aged 75 years or more with known or suspected CAD and may have a role in risk stratification of this patient population.

• 社団法人日本循環器学会の論文
• 2007-06-20

著者

• IGARASHI Yuko

  Department of Cardiology, Tokyo Medical University

• CHIKAMORI Taishiro

  Department of Cardiology, Tokyo Medical University

• HIDA Satoshi

  Department of Cardiology, Tokyo Medical University

• NAGAO Tadashi

  Department of Cardiology, Tokyo Medical University

• YAMASHINA Akira

  Department of Cardiology, Tokyo Medical University

• Yamashina Akira

  武蔵野赤十字病院

• Yamazaki Junichi

  Department of Cardiovascular Medicine, Toho University Omori Medical Center

• Hida S

  Department Of Cardiology Tokyo Medical University

• Ikarashi Yuuko

  Department Of Cardiology Tokyo Medical University

• Nagao Tadashi

  Department Of Cardiology Tokyo Medical University

• Kuwabara Yoichi

  Department Of Cardiovascular Science And Medicine Chiba University Graduate School Of Medicine

• Yokozuka Koichi

  Kanazawa University Hospital

• Nishimura Shigeyuki

  Department Of Cardiology Saitatama International Medical Center Saitama Medical Univeristy

• Nishimura Shigeyuki

  Division Of Cardiology Saitama Medical School Of Hospital

• Nakahara Takao

  Departments Of Cardiology Tokyo Medical University

• Nakata Tomoaki

  Second Department Of Internal Medicine Sapporo Medicine University

• Kuwabara Yoichi

  Department Of Cardiology Tokyo Medical University

• Chikamori Taishiro

  Department Of Cardiology Tokyo Medical University

• Tamaki Nagara

  Hokkaido University School Of Medicine Department Of Tracer Kinetics And Department Of Nuclear Medic

• Nishimura Shigeyuki

  Department Of Cardiovascular Medicine Graduate School Of Medicine Chiba University

• Hida Satoshi

  Department Of Cardiology Tokyo Medical University

• Tamaki Nagara

  Hokkaido University Nuclear Medicine

• Nishimura Shigeyuki

  Department Of 2^<nd> Internal Medicine Saitama Medical School

• Yamazaki Junichi

  Department Of Cardiology Toho University School Of Medicine

• Yamashina Akira

  Department Of Cardiology Tokyo Medical University

• Yamazaki Junichi

  Department Of Cardiology Saitama Medical University

• Yamazaki Junichi

  Department Of Biofunctional Science Faculty Of Agriculture And Life Science Hirosaki University

• Tamaki Nagara

  Department Of Nuclear Medicine Hokkaido University School Of Medicine

• Tamaki Nagara

  Hokkaido University Graduate School Of Medicine Department Of Nuclear Medicine

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