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Updated: Sep 21, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
[Normal and Near Normal Myocardial Perfusion Imaging Data Analysis: Two-Year Major Adverse Cardiac Event]
Li-Hua Tang1, Yih-Hwen Huang2, Chien-Jung Chen3
1MSN, RN, Department of Nuclear Medicine, National Taiwan University Hospital, Taiwan, ROC.
Background:
Myocardial perfusion imaging (MPI) is the method most commonly used to assess patients with suspected coronary artery disease for the presence of myocardial ischemia and risk of subsequent adverse cardiac events. Studies are limited on the incidence of major adverse cardiac event (MACE) in patients with normal MPI results.
Purpose:
The aim of this study was to investigate the incidence and risk factors of MACE in patients with normal or near-normal MPI results.
Methods:
In this single-center retrospective chart review study, patients who had received MPI tests at a nuclear medicine department of a medical center in 2017 were consecutively enrolled. All of the participants in this study were patients with normal or near-normal MPI results, and were followed for two years to assess the incidence of MACE (death, hospitalized for percutaneous coronary intervention; CABG, heart failure and stroke). Participants with or without MACE were compared to determine whether demographic, comorbidity, and MPI data were significant risk factors.
Results:
Of the 1,629 participants (age = 70.4 ± 11.3 years, 49.4% male) enrolled, 387 (23.8%) were classified into the normal MPI group and 1,242 (76.2%) were classified into the near-normal MPI group. Notably, 61 participants (15.8%) in the normal MPI group and 206 (16.6%) in the near-normal MPI group experienced MACE events during the two-year follow-up. The risk factors of MACE identified in this study included being older in age, being male, and having poor myocardial perfusion parameters (i.e., ejection fraction) during MPI.
Conclusions / Implications For Practice:
Over the two-year study period, 15.8% of the participants with normal MPI results and 16.6% of those with near-normal MPI results experienced major adverse cardiac events. Thus, it is critical to inform patients regarding the potential risk of MACE risk and to educate them on how to mitigate this risk by actively managing their hyperlipidemia level and left ventricular ejection fraction.
Insights
Even with normal myocardial perfusion imaging (MPI) results, patients face a significant risk of major adverse cardiac events (MACE). Risk factors include age, male sex, and reduced ejection fraction, highlighting the need for proactive cardiac risk management.
Area of Science:
- Cardiology
- Nuclear Medicine
- Preventive Cardiology
Background:
- Myocardial perfusion imaging (MPI) is standard for assessing coronary artery disease, myocardial ischemia, and cardiac event risk.
- Limited data exists on major adverse cardiac event (MACE) incidence in patients with normal MPI results.
Purpose of the Study:
- To determine the incidence and identify risk factors for MACE in patients with normal or near-normal MPI results.
Main Methods:
- Retrospective chart review of 1,629 patients undergoing MPI in 2017.
- Two-year follow-up to track MACE (death, PCI, CABG, heart failure, stroke).
- Comparison of demographic, comorbidity, and MPI data between patients with and without MACE.
Main Results:
- Overall MACE incidence was 15.8% in the normal MPI group and 16.6% in the near-normal MPI group over two years.
- Identified risk factors for MACE included older age, male sex, and poor ejection fraction on MPI.
- No significant difference in MACE rates between normal and near-normal MPI groups.
Conclusions:
- A notable percentage of patients with normal or near-normal MPI experience MACE, underscoring the need for continued risk assessment.
- Patients should be informed about MACE risk and educated on managing risk factors like hyperlipidemia and left ventricular ejection fraction.
