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

Introduction: 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). Material and Methods: 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. Results: 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). Conclusion: Our data confirmed that patients with a normal 99mTc-Sestamibi myocardial SPECT are associated with a very low incidence of cardiovascular events.