Influence of Mode of Stress and Coronary Risk Factor Burden Upon Long-Term Mortality Following Normal Stress Myocardial Perfusion Single-Photon Emission Computed Tomographic Imaging

In patients with normal results on stress single-photon emission computed tomographic (SPECT) studies, coronary artery disease risk factors (RFs) and the mode of testing can influence the trajectory of long-term outcomes. Nevertheless, the combined prognostic impact of these commonly assessed factors has heretofore not been considered. In this study, all-cause mortality rates were assessed in 5,762 patients with normal results on stress SPECT studies. Patients were divided according to mode of stress testing, exercise or pharmacologic, and by number of coronary artery disease RFs. Patients were followed for a mean of 8 ± 4.2 years for all-cause mortality. There were 1,051 deaths (18%), with an annualized mortality rate of 2.2% per year. The RF-adjusted event rate was significantly higher for pharmacologic versus exercise SPECT studies (3.6% per year vs 1.2% per year, p