Kamal A M, Fattah A A, Pancholy S, Aksut S, Cave V, Heo J, Iskandrian A S
Philadelphia Heart Institute, Presbyterian Medical Center, PA 19104, USA.
J Nucl Cardiol. 1994 May-Jun;1(3):254-61. doi: 10.1007/BF02940339.
This study examined the prognostic value of adenosine single-photon emission computed tomographic thallium imaging in medically treated patients with angiographic evidence of coronary artery disease (CAD).
Patients who underwent coronary revascularization within 3 months of this study were excluded. There were 177 patients aged 64 +/- 11 years; 74 had one-vessel, 57 had two-vessel, and 46 had three-vessel CAD (> or = 50% diameter stenosis). During a mean follow-up of 22 +/- 13 months, there were 14 events (cardiac death or nonfatal myocardial infarction). Cox survival analysis with important clinical, catheterization, and scintigraphic variables identified the size of perfusion abnormality as the strongest predictor of events (chi 2 = 9). Life-table analysis showed that patients with perfusion defects of 15% or greater of the myocardium had a worse prognosis than had patients with no or smaller defects (Mantel-Cox statistic = 13; p < 0.001).
Thus adenosine single-photo emission computed tomographic thallium imaging provides important prognostic data in medically treated patients with CAD. The extent of thallium abnormality is the most important predictor of events.
本研究探讨了腺苷单光子发射计算机断层心肌灌注显像对接受药物治疗且有冠状动脉疾病（CAD）血管造影证据患者的预后价值。
排除在本研究3个月内接受冠状动脉血运重建的患者。共有177例年龄为64±11岁的患者；74例为单支血管病变，57例为双支血管病变，46例为三支血管病变（直径狭窄≥50%）。在平均22±13个月 的随访期间，发生了14起事件（心源性死亡或非致命性心肌梗死）。对重要的临床、心导管检查和闪烁显像变量进行Cox生存分析，结果显示灌注异常的范围是事件的最强预测因素（χ2 = 9）。寿命表分析表明，心肌灌注缺损达15%或更大的患者比无灌注缺损或灌注缺损较小的患者预后更差（Mantel-Cox统计量 = 13；p < 0.001）。
因此，腺苷单光子发射计算机断层心肌灌注显像可为接受药物治疗的CAD患者提供重要的预后数据。铊异常的范围是事件的最重要预测因素。
