One-year prognosis of patients with normal myocardial perfusion imaging using technitium-99m sestamibi in suspected coronary artery disease: a single-center experience of 1,047 patients

Abstract

The aim of the present study was to evaluate the clinical outcome of a normal stress technetium-99m (99mTc)-Sestamibi single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) with different probabilities of coronary artery disease (CAD). A total of 1,047 subjects with a normal 99mTc-MIBI SPECT were followed up for one year and hard and soft cardiac events were assessed. Hard cardiac events were defined as cardiac death or non-fatal myocardial infarction (MI). Soft cardiac events included the patient's development of recurrent chest pain requiring coronary revascularization or significant stenosis in coronary arteries on angiography. Overall, 1,047 patients (248 men and 799 women; mean age: 60.07 ± 12.31, range 29-92) were enrolled. Three hard cardiac events occurred in the groups; two had cardiac arrest and one non-fatal MI. As a result, the annualized hard cardiac event rate was 0.28%, the annualized cardiac mortality rate was 0.19%, and the rate of overall annualized cardiac events was 1.25%. Furthermore, there was a significant difference in cardiac events among patients with various pretest likelihoods of CAD (p value=0.04). Our data confirmed that patients with a normal 99mTc-Sestamibi myocardial SPECT are associated with a very low incidence of cardiovascular events.