Accuracy of ⁸²Rb PET/CT Myocardial Perfusion Imaging with Regadenoson Stress, Including 3-Year Clinical Outcomes

The purpose of this study was to determine the clinical accuracy of ⁸²Rb PET/CT myocardial perfusion imaging (MPI) when performed with regadenoson stress in a U.S. Department of Veterans Affairs (VA) population of patients. Methods: The initial cohort of 480 patients undergoing vasodilator PET MPI with regadenoson stress at our institution from September 2009 through July 2010 was closely tracked for short-term outcomes based on correlation with invasive coronary catheterization. Long-term outcomes were determined by major adverse cardiac event rates based on data extraction from the electronic medical record and grouped by summed stress score (SSS) for a 3-y period. Results: At the 3-y follow-up, there had been 31 patient deaths, 5 of which were heart-related. Twenty-four patients had documented myocardial infarctions. Event rates and cardiac death rates were highly predicted by the results of PET MPI. Seventy patients underwent invasive cardiac catheterization within 60 d of the PET MPI. Patients were increasingly likely to undergo catheterization as their SSS increased. Catheterization correlation demonstrated a sensitivity of 95%, a positive predictive value of 88.4% for significant coronary artery disease, and an overall accuracy of 86% for PET MPI with regadenoson stress when compared with invasive catheterization. Conclusion: PET MPI with regadenoson stress demonstrates high accuracy when correlated with invasive catheterization and clinical outcomes. The SSS was highly predictive of cardiac events and patient survival in a VA population over a 3-y period of clinical follow-up.