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SPECT Imaging Helps Judge Sudden Cardiac Death Risk

For those with preserved LVEF, imaging adds prognostic data to identify higher-risk subset

WEDNESDAY, July 7 (HealthDay News) -- For patients with coronary artery disease (CAD) and left ventricular ejection fraction (LVEF) greater than 35 percent, single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) can help identify those at higher risk for sudden cardiac death (SCD), according to a study in the July 13 issue of the Journal of the American College of Cardiology.

Jonathan P. Piccini, M.D., of Duke University in Durham, N.C., and colleagues studied 4,865 CAD patients with LVEF of more than 35 percent who had undergone gated SPECT MPI. The relationship between SCD and patient characteristics was examined.

The researchers found that, in a median 6.5 years of follow-up, 161 of the patients experienced SCD. The factors associated with SCD included LVEF, Charlson index, hypertension, smoking, antiarrhythmic therapy, and the summed stress score. Adding perfusion data to clinical history and LVEF was linked to greater discrimination for SCD events. Among the 26 high-risk patients identified by SPECT MPI, two patients experienced SCD. However, out of 79 patients who did suffer SCD, the SPECT nomogram failed to identify 77 as high risk.

"Among patients with CAD and preserved left ventricular function, SPECT MPI defects are associated with an increased risk of SCD. SPECT perfusion imaging adds incremental prognostic information to the clinical history for the prediction of SCD. Further validation of these findings and prospective studies should address the role of SPECT perfusion imaging for the risk stratification of SCD in patients with CAD and LVEF >35 percent," the authors write.

The study was funded by a grant from General Electric Health. Study authors disclosed financial relationships with medical device companies, including General Electric Health in the case of one author.

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