The coronary artery XXXX score and stress myocardial perfusion imaging provide independent and complementary prediction of cardiac risk.

@entity1 @entity453 @entity460 @entity299 @entity583 @entity204 @entity65
OBJECTIVES: This study sought to examine the relationship between coronary artery @entity460 score (CACS) and single-photon emission computed tomography (SPECT) results for predicting the short- and long-term risk of @entity299 . BACKGROUND: The CACS and SPECT results both provide important prognostic information. It is unclear whether integrating these tests will better predict @entity1 outcome. METHODS: We followed-up 1,126 generally asymptomatic subjects without previous @entity65 who had a CACS and stress SPECT scan performed within a close time period (median 56 days). The median follow-up was 6.9 years. End points analyzed were total @entity299 and all-cause @entity583 ( @entity583 ). RESULTS: An abnormal SPECT result increased with increasing CACS from <1% (CACS < or =10) to 29% (CACS >400) (p < 0.001). Total @entity299 and @entity204 / @entity583 also increased with increasing CACS and abnormal SPECT results (p < 0.001). In subjects with a normal SPECT result, CACS added incremental prognostic information, with a 3.55-fold relative increase for any @entity299 (2.75-fold for @entity204 / @entity583 ) when the CACS was severe (>400) versus minimal (< or =10). Separation of the survival curves occurred at 3 years after initial testing for all @entity299 and at 5 years for @entity204 / @entity583 . CONCLUSIONS: The CACS and SPECT findings are independent and complementary predictors of short- and long-term @entity299 . Despite a normal SPECT result, a severe CACS identifies subjects at high long-term cardiac risk. After a normal SPECT result, our findings support performing a CACS in @entity1 who are at intermediate or high clinical risk for @entity453 to better define those who will have a high long-term risk for adverse @entity299 .
