Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
J Nucl Cardiol. 2013 Jun;20(3):347-57. doi: 10.1007/s12350-013-9696-0. Epub 2013 Mar 1.
The prognostic value of a normal myocardial perfusion scintigraphy (MPS) may be well described, but long-term follow-up data are sparse, and temporal variations in risk are insufficiently elucidated.
During long-term follow-up (mean 6.2 years) of 1,327 consecutive Danish patients with normal MPS, the rate of all-cause death (ACD) was 1.9%/year (differing by gender) and of cardiac death (CD)/myocardial infarction (MI) 0.8%/year (differing by coronary artery disease, CAD). Female gender (HR: 0.60), age (HR: 1.07 per-year increment), and known CAD without prior revascularization (HR: 2.17) were statistically significant factors for ACD, whereas diabetes and previous MI per se were not. Known CAD with previous revascularization carried a low risk of ACD when adjusted for gender and age (HR: 0.56). For CD/MI, risk increased with age and threefold with known CAD, previous MI, and previous percutaneous coronary intervention. Judged from smoothed hazard functions, mortality risk increased further with time for men, elderly, and diabetics and markedly further with known CAD without prior revascularization.
Following a normal MPS, rates of death and hard cardiac events were low. Risk varied with age, gender, and disease history. Novel aspects of temporal risk variation suggested a general warranty period of 5 years, but less in risk groups.
正常心肌灌注闪烁显像（MPS）的预后价值可能描述得很好，但长期随访数据较少，风险的时间变化也未得到充分阐明。
在对 1327 例丹麦连续正常 MPS 患者进行的长期随访（平均 6.2 年）中，全因死亡率（ACD）为 1.9%/年（性别差异），心脏性死亡率（CD）/心肌梗死（MI）为 0.8%/年（冠心病（CAD）差异）。女性（HR：0.60）、年龄（HR：每年增加 1.07）和未经再血管化的已知 CAD 是 ACD 的统计学显著因素，而糖尿病和既往 MI 本身并非如此。已知 CAD 伴先前血运重建，在调整性别和年龄后 ACD 的风险较低（HR：0.56）。对于 CD/MI，风险随年龄增加，已知 CAD、既往 MI 和既往经皮冠状动脉介入治疗增加三倍。从平滑危险函数判断，男性、老年人和糖尿病患者的死亡率风险随时间进一步增加，而无先前再血管化的已知 CAD 患者的死亡率风险则显著增加。
在正常 MPS 后，死亡率和严重心脏事件的发生率较低。风险随年龄、性别和病史而变化。时间风险变化的新方面表明一般保证期为 5 年，但在风险组中则较短。
