Potential impact of noncontrast computed tomography as gatekeeper for myocardial perfusion positron emission tomography in patients admitted to the chest pain unit

The American Journal of Cardiology
Fabio P EstevesPaolo Raggi

Abstract

We investigated the ability of coronary artery calcium (CAC) to predict a normal adenosine stress rubidium-82 (Rb-82) myocardial perfusion positron emission tomography (PET) in patients admitted to the chest pain unit. Eighty-four consecutive patients (33 men; mean age 62 +/- 14.8 years) with low to intermediate likelihood of coronary artery disease were included. A single noncontrast computed tomogram under shallow breathing was obtained for attenuation correction and to assess the presence of CAC. This was followed by a rest and adenosine stress dynamic Rb-82 emission PET. Computed tomography and PET images were interpreted independently. There was a high prevalence of risk factors (80% hypertension, 30% diabetes, 38% hypercholesterolemia, 13% smoking); prior coronary revascularization and myocardial infarction were present in 21% and 15% of the patients, respectively. The absence of CAC was associated with a normal adenosine stress Rb-82 myocardial perfusion PET in 34 of 34 patients, yielding a negative predictive value of 100%. The presence of CAC (50 of 84) was associated with a higher incidence of myocardial perfusion defects (13 of 50), yielding a positive predictive value of 26%. Sensitivity was 100% (13 of 13) and spec...Continue Reading

References

Jul 14, 2001·Journal of the American College of Cardiology·D GeorgiouB H Brundage
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Citations

Apr 18, 2016·JACC. Cardiovascular Imaging·Chirag BavishiAlan Rozanski
Jan 3, 2009·Journal of the American College of Cardiology·Raymond J GibbonsEric E Williamson
Jun 13, 2009·JACC. Cardiovascular Imaging·Ammar SarwarKhurram Nasir
May 11, 2017·Circulation. Cardiovascular Imaging·Daniel O BittnerMaros Ferencik
Jan 1, 2008·The Open Cardiovascular Medicine Journal·Anil George, Assad Movahed
Sep 30, 2009·Nature Reviews. Cardiology·Nikolaos Alexopoulos, Paolo Raggi
Jul 25, 2012·Critical Pathways in Cardiology·Rajesh Tota-MaharajRoger S Blumenthal
Jul 18, 2008·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Andreas K BuckAlexander Drzezga
Feb 20, 2009·Revista española de cardiología·José A BarrabésAlfredo Bardají

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