628Long-term prognosis in patients with stable angina and discordant results of single-photon emission computed tomography and ECG exercise test


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Abstract

Purpose: To evaluate the clinical prognostic significance of discordant results of single-photon emission computed tomography (SPECT) and ECG exercise test (ExT) performed in patients with stable angina in long-term follow-up.Methods: 381 patients (pts) with suspected or known stable coronary artery disease underwent 99mTc-methoxyisobutylisonitrile (MIBI) SPECT and ExT. SPECT was considered positive (+) if inducible perfusion defects were detected. ExT was evaluated using widely accepted criteria. Based on the results of both examinations the patients were divided into 4 subgroups: group 1 (52pts) –SPECT (+) and ExT (+), group 2 (123 pts) – SPECT (+) and ExT (-), group 3 (76 pts) – SPECT (-) and ExT (+), group 4 (130 pts) – SPECT (-) and ExT (-). The mean clinical follow-up duration was 58±8 months.Results: All clinical end-points were more prevalent in groups 1 and 2 than in groups 3 and 4 (table 1), but the statistical significance was reached only by the following differences: group 1 vs group 4 and group 2 vs group 4 in prevalence of acute coronary syndromes, cardiac hospitalizations and coronary revascularizations.Conclusion: In long-term follow-up positive SPECT result is associated with worse clinical outcome irrespective of ExT result.

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