RESUMO
Objective: The aim of our study was to evaluate the prognostic value of gated SPECT MPI in non-obstructed coronary arteries (INOCA) patients, sought to stratify patients more accurately and thus derive more reliable prognostic information. Materials and methods: In total, 167 patients with INOCA were enrolled. The patients were divided into two groups according to their SSS. Patients were followed-up regularly in terms of major adverse cardiovascular event (MACE), including cardiac death, nonfatal myocardial infarction, stroke, re-hospitalization with angina pectoris, and recurrent angina pectoris. Kaplan-Meier curves and Cox's proportional hazards models were used to analyze survival and identify predictive factors. Results: Adverse cardiac events occurred in 33 cases (19.8%). The rate of MACE was higher in the summed stress score (SSS) ≥4 group than in the SSS 0-3 group (30.1% vs. 9.5%, respectively, P = 0.001) and MACE-free survival was lower (annual MACE-free rates of 87.5% vs. 96.2%, respectively, P = 0.003). Event-free survival was consistently higher in patients with normal arteries than in those with non-obstructive coronary artery disease (annual MACE-free rates of 96.1% and 88.4%, P = 0.035). When the SSS and the CAG results were combined, patients with normal coronary arteries (SSS 0-3) had the best prognosis and those with non-obstructive coronary artery stenosis (SSS ≥ 4) had the worst. However, the early prognosis of patients with non-obstructive coronary artery disease and SSS of 0-3 was comparable to that of patients with normal coronary arteries and SSS ≥ 4 (annual MACE-free rates of 100%, 94.6%, 93.1%, and 78.2%, respectively). Multivariate Cox's regression indicated that the SSS [hazard ratio (HR) = 1.126, 95% confidence interval (CI) 1.042-1.217, P = 0.003] and non-obstructive coronary artery disease (HR = 2.559, 95% CI 1.249-5.246, P = 0.01) were predictors of adverse cardiac events. Conclusion: SPECT MPI data were prognostic for INOCA patients, thus identifying groups at high risk. The long-term predictive efficacy of such data exceeded that of CAG data. A combination of the two measures more accurately stratified INOCA patients in terms of risk.
RESUMO
OBJECTIVE: To investigate the evaluation value of invasion area PET-CT scanning for chemotherapeutic efficacy and prognosis of patients with lymphoma. METHODS: A total of 98 newly diagnosed patients with lymphoma received the chemotherapy by R-CHOP protocol, the PET-CT scan of whole body and invasion area was performed after 6 cycle of chemotherapy. The invasion area was determined by PET-CT scan results before chemotherapy. The difference of clinical stage, clinical efficacy, radiation dose and scanning time were compared between PET-CT scanning of whole body and invasion area. RESULTS: The clinical stages of PET-CT scaning of whole body and invasion area were complete consistent, the consisitent rate of clinical stages from whole body and invasion area PET-CT scaning with Ann Arbor staging was 95.9%(94/98). Whole body PET-CT scan showed that 68 cases achieved CR, 26 cases achieved PR, 1 case achieved SD, 3 cases achieved PD. PET-CT scan of invasion area showed that 68 cases achieved CR, 24 cases achieved PR, 2 cases achieved SD, and 4 cases achieved PD; the PET-CT scan results of the whole body and the invasion area was consistent with CR. In 68 patients with CR, the radiation dose of CT, PET and PET-CT was significantly lower than that of whole body PET-CT, and the scanning time was significantly less than that of whole body PET-CT (P < 0.05). CONCLUSION: For clinical efficicacy with CR patients, the scan results of whole body and invasion area PET-CT are consistent, and the PET-CT invasion area can significantly reduce the radiation dose and scanning time; and for PR, SD and PD patients, the whole body PET-CT scan should be performed to evaluation clinical efficiency.
