Prognostic value of thallium-201 single-photon emission computed tomography for patients with multivessel coronary artery disease after revascularization (the emory angioplasty versus surgery trial [EAST])

作     者：Alazraki, NP Krawczynska, EG Kosinski, AS DePuey, EG Ziffer, JA Taylor, AT Pettigrew, RI Vansant, JP Shaw, LJ Weintraub, WS King, SB 

作者机构：Emory Univ Sch Med Dept Radiol Div Nucl Med Atlanta GA 30322 USA Emory Univ Sch Med Dept Biostat Rollins Sch Publ Hlth Atlanta GA 30322 USA Emory Univ Sch Med Dept Med Div Cardiol Atlanta GA 30322 USA 

出 版 物：《AMERICAN JOURNAL OF CARDIOLOGY》 (美国心脏病学杂志)

年 卷 期：1999年第84卷第12期

页      面：1369-1374页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：NHLBI NIH HHS [R01 HL 33965] Funding Source: Medline 

主　　题：血管成形术 经腔 经皮冠状动脉 死亡原因 冠状动脉分流术 冠状动脉循环/生理学 冠心病/死亡率 冠心病/放射性核素显像 冠心病/外科学 运动试验 随访研究 移植物闭塞 血管/死亡率 移植物闭塞 血管/放射性核素显像 心肌梗死/死亡率 心肌梗死/放射性核素显像 手术后并发症/死亡率 手术后并发症/放射性核素显像 预后 存活率 铊放射性同位素/诊断应用 体层摄影术 发射型计算机 单光子 老年人 人类 中年人 

摘      要：The aim of this study was to investigate the relation between reversible thallium single-photon emission computed tomegraphy (SPECT) myocardial perfusion defects at 1-year after revascularization and quantitative indexes in Emery Angioplasty versus Surgery Trial (EAST) and outcomes 3 years after revascularization in 336 patients. EAST was a randomized controlled trial assessing cardiac outcomes for angioplasty versus bypass surgery for patients with multivessel coronary artery disease. During this prospective trial, a substudy included the evaluation of the prognostic value of reversible defects on quantitative thallium SPECT. At 1-year after revascularization, 336 patients underwent SPECT thallium-201 stress myocardial perfusion and 3-hour delayed imaging. Subsequent events, percutaneous transluminal coronary angioplasty, coronary artery bypass graft surgery, myocardial infarction, and death, were recorded at 3 years. A stress-induced reversible thallium-201 defect was defined using a quantitative index of a reversibility score 30% and severity score 500. Reversible defects were observed more frequently in the percutaneous transluminal coronary angioplasty than in the coronary artery bypass graft surgery treatment groups (46% vs 27%, p 0.001). A fetal of 123 patients had stress-induced, reversible thallium defects and more events than patients with other perfusion results (freedem from ail events was 81.3% vs 94% [p 0.001], and freedom from myocardial infarction and death 88.3% vs 95.5% [p = 0.031]). Quantitative thallium SPECT at 1 year after revascularization risk stratifies patients as to their likelihood of major cardiac outcomes. (C) 1999 by Excerpta Medico, Inc.