Stress-Only Heart Imaging May Be Sufficient

Study finds additional rest imaging unlikely to impact survival but increases radiation dose
By A. Agrawal, PhD
HealthDay Reporter

TUESDAY, Nov. 17 (HealthDay News) -- Additional rest imaging is unlikely to have an effect on survival but increases radiation dose in patients whose stress myocardial perfusion imaging is normal, according to a study published online Nov. 11 in the Journal of the American College of Cardiology.

Su Min Chang, M.D., of the Methodist Hospital in Houston, and colleagues compared mortality among 16,854 patients who had a normal stress single-photon emission computed tomographic (SPECT) myocardial perfusion tomography. Stress-only SPECT was completed in 8,034 patients, while 8,820 patients underwent both stress and rest imaging.

The researchers found that mortality rates were similar in the two groups after adjusting for baseline clinical characteristics. However, patients who underwent the stress-only SPECT received a 61 percent lower dose of radiopharmaceuticals. While older patients, males, diabetes patients, patients with a history of coronary artery disease, and patients unable to exercise had worse survival, the type of SPECT imaging was not associated with survival.

"In this issue of the Journal, Chang et al provide convincing evidence that patients with normal stress-only images have the same low mortality as patients with normal images on the basis of evaluation of both the stress and rest images," writes the author of an accompanying editorial.

The author of the editorial reported a consulting relationship with Gilead Sciences Inc.

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