Abstract
One of the major strengths of nuclear myocardial perfusion imaging (MPI) is the robust prognostic databases from observational studies demonstrating significantly different outcomes in patients with low-risk vs high-risk scans. The severity of the MPI defect can be semi-quantitated using the summed stress score (SSS) and summed difference score (SDS). SSS is more strongly associated with mortality, whereas SDS is the better predictor of subsequent coronary angiography and revascularization. The strength of MPI variables as prognostic indicators decreases when adjusted for prognostically important clinical and stress test variables. Nonetheless, most studies of general patient populations have demonstrated that MPI adds incremental prognostic value to clinical and stress test information. In contrast to these positive results from observational studies, the application of MPI ischemia as a treatment guide in several recent trials (DIAD, WOMEN, COURAGE, BARI 2D, STICH) has largely failed to identify patient subsets with improved outcome. This issue will continue to be investigated in the ongoing PROMISE and ISCHEMIA trials.
| Original language | English (US) |
|---|---|
| Journal | Current Cardiology Reports |
| Volume | 16 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jan 1 2014 |
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Keywords
- Coronary artery disease
- Ischemia
- MPI (myocardial perfusion imaging)
- Prognosis
- SPECT (single photon emission computed tomography)
- Summed difference score
- Summed stress score
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Assessing clinical impact of myocardial perfusion studies : Ischemia or other prognostic indicators? / Miller, Todd D.; Askew, John Wells; Herrmann, Joerg.
In: Current Cardiology Reports, Vol. 16, No. 4, 01.01.2014.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Assessing clinical impact of myocardial perfusion studies
T2 - Ischemia or other prognostic indicators?
AU - Miller, Todd D.
AU - Askew, John Wells
AU - Herrmann, Joerg
PY - 2014/1/1
Y1 - 2014/1/1
N2 - One of the major strengths of nuclear myocardial perfusion imaging (MPI) is the robust prognostic databases from observational studies demonstrating significantly different outcomes in patients with low-risk vs high-risk scans. The severity of the MPI defect can be semi-quantitated using the summed stress score (SSS) and summed difference score (SDS). SSS is more strongly associated with mortality, whereas SDS is the better predictor of subsequent coronary angiography and revascularization. The strength of MPI variables as prognostic indicators decreases when adjusted for prognostically important clinical and stress test variables. Nonetheless, most studies of general patient populations have demonstrated that MPI adds incremental prognostic value to clinical and stress test information. In contrast to these positive results from observational studies, the application of MPI ischemia as a treatment guide in several recent trials (DIAD, WOMEN, COURAGE, BARI 2D, STICH) has largely failed to identify patient subsets with improved outcome. This issue will continue to be investigated in the ongoing PROMISE and ISCHEMIA trials.
AB - One of the major strengths of nuclear myocardial perfusion imaging (MPI) is the robust prognostic databases from observational studies demonstrating significantly different outcomes in patients with low-risk vs high-risk scans. The severity of the MPI defect can be semi-quantitated using the summed stress score (SSS) and summed difference score (SDS). SSS is more strongly associated with mortality, whereas SDS is the better predictor of subsequent coronary angiography and revascularization. The strength of MPI variables as prognostic indicators decreases when adjusted for prognostically important clinical and stress test variables. Nonetheless, most studies of general patient populations have demonstrated that MPI adds incremental prognostic value to clinical and stress test information. In contrast to these positive results from observational studies, the application of MPI ischemia as a treatment guide in several recent trials (DIAD, WOMEN, COURAGE, BARI 2D, STICH) has largely failed to identify patient subsets with improved outcome. This issue will continue to be investigated in the ongoing PROMISE and ISCHEMIA trials.
KW - Coronary artery disease
KW - Ischemia
KW - MPI (myocardial perfusion imaging)
KW - Prognosis
KW - SPECT (single photon emission computed tomography)
KW - Summed difference score
KW - Summed stress score
UR - http://www.scopus.com/inward/record.url?scp=84894490501&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84894490501&partnerID=8YFLogxK
U2 - 10.1007/s11886-014-0465-8
DO - 10.1007/s11886-014-0465-8
M3 - Review article
C2 - 24585107
AN - SCOPUS:84894490501
VL - 16
JO - Current Cardiology Reports
JF - Current Cardiology Reports
SN - 1523-3782
IS - 4
ER -