Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
PLoS One. 2021 Oct 26;16(10):e0258983. doi: 10.1371/journal.pone.0258983. eCollection 2021.
Myocardial perfusion imaging (MPI) is a well-established diagnostic tool to evaluate coronary artery disease (CAD) and also an effective prognostic tool for patients with CAD. However, few studies investigated the prognostic value of attenuation correction (AC) in MPI, and the results were controversial.
To investigate the prognostic value of computed tomography (CT)-based AC thallium-201 (Tl-201) MPI.
A total of 108 consecutive patients who underwent Tl-201 MPI and received coronary angiography within 90 days were included. Medical records were reviewed and missing information was completed after telephone contact. The prognostic value was evaluated by Kaplan-Meier analysis, univariable and multivariable Cox proportional hazards model.
After a mean follow-up of 7.72 ± 3.72 years, 27 patients had died, 41 had been readmitted for cardiovascular (CV)-related events and 44 had reached the composite of death plus CV-related re-admission. Kaplan-Meier curves for all-cause mortality for SSS with a cutoff value of 13 for AC and 16 for non-AC (NAC) images showed a significant difference between the two curves for both AC and NAC images (p = 0.011 for AC and p = 0.021 for NAC). In the multivariable model, SSS and SRS showed similar independent predictive values in predicting all-cause mortality and composite of all-cause mortality plus CV-related re-admission, in both AC and NAC images. Subgroup analysis implicated that AC MPI possibly provided better risk stratification in obese patients.
CT-based AC and NAC MPI showed similar value and were the only significant predictors for the composite of mortality and CV events.
心肌灌注成像（MPI）是一种评估冠状动脉疾病（CAD）的成熟诊断工具，也是 CAD 患者的有效预后工具。然而，很少有研究调查 CT 衰减校正（AC）在 MPI 中的预后价值，而且结果存在争议。
探讨基于计算机断层扫描（CT）的 AC 铊-201（Tl-201）MPI 的预后价值。
共纳入 108 例连续患者，他们接受了 Tl-201 MPI 检查，并在 90 天内接受了冠状动脉造影。回顾病历记录，并通过电话联系补充缺失信息。采用 Kaplan-Meier 分析、单变量和多变量 Cox 比例风险模型评估预后价值。
平均随访 7.72±3.72 年后，27 例患者死亡，41 例因心血管（CV）相关事件再次入院，44 例达到死亡加 CV 相关再次入院的复合终点。对于 AC 和非 AC（NAC）图像的 SSS 截断值为 13 的全因死亡率，Kaplan-Meier 曲线显示两种图像之间存在显著差异（AC 为 p=0.011，NAC 为 p=0.021）。在多变量模型中，SSS 和 SRS 在预测全因死亡率和全因死亡率加 CV 相关再入院的复合终点方面，在 AC 和 NAC 图像中具有相似的独立预测价值。亚组分析表明，AC MPI 可能在肥胖患者中提供更好的风险分层。
基于 CT 的 AC 和 NAC MPI 具有相似的价值，是全因死亡率和 CV 事件复合终点的唯一显著预测因素。
