Myocardial perfusion imaging with 13N-Ammonia PET is a strong predictor for outcome

Background/objectives: The aim of the present study was to assess the long-term predictive value of myocardial perfusion imaging (MPI) with N-13-ammonia positron emission tomography (PET) in patients with suspected myocardial perfusion abnormality. At present, outcome data on the predictive value of MPI in N-13-ammonia PET exist only for rather small patient populations. Methods: Cardiac perfusion was assessed in 943 consecutive patients using N-13-ammonia PET, and follow-up was obtained in 698 (74%). 77 patients who underwent early revascularization (<60 days) were excluded and 621 patients were assigned to normal versus abnormal perfusion for outcome analysis. Hard events (cardiac death and non-fatal myocardial infarction) and major adverse cardiac events (MACE; hard events, hospitalization for cardiac reasons and late revascularization) were investigated using the Kaplan-Meier method. Independent predictors for various cardiac events were identified using Cox proportional hazard regression analysis. Results: During follow-up (5.7 +/- 2.5 years), 275 patients had at least 1 cardiac event, including 102 cardiac deaths and 33 non-fatal myocardial infarction. Abnormal perfusion (n=469) was associated with a higher incidence of MACE (P<0.001) and hard events (P<0.001) throughout the 10-year follow-up period. Conclusions: Cardiac perfusion findings in N-13-ammonia PET are strong predictors of long-term outcome. (C) 2012 Elsevier Ireland Ltd. All rights reserved.