Prognostic value of normal technetium-99m-sestamibi cardiac imaging.

Abstract

The purpose of this study was to describe the clinical outcome of patients with a normal 99mTc-sestamibi cardiac imaging study. One-day gated rest-stress planar dipyridamole (n = 112) and symptom-limited exercise (n = 122) 99mTc-sestamibi protocols were used. All patients (n = 234, mean age 55 +/- 12 yr, 127 males and 107 females) had normal perfusion and wall motion on qualitative analysis. Patients were followed for 6-16 mo (mean 10 +/- 2 mo). Cardiac events were defined as cardiac death or nonfatal myocardial infarction. ST-segment depression or chest pain occurred in 8 (7%) and 29 (26%) patients in the dipyridamole group, respectively, and 20 (16%) and 28 (22%) patients in the exercise group. Cardiac events occurred in only one patient. The annualized event rate was 0.5% per year. In addition, only two patients underwent coronary revascularization during the follow-up period. Our data confirm the benign outcome of patients with normal 99mTc-sestamibi cardiac imaging, at least over an intermediate follow-up period.