Abstract 320: Low Prevalence of Ischemia and Excellent Prognosis in an Intermediate-Risk Cohort Achieving ≥10 METS on Exercise Myocardial Perfusion Imaging: Was SPECT Imaging Necessary?

Introduction: Increasing yearly volumes of stress myocardial perfusion imaging (MPI) are a cost burden on the healthcare system. The benefit of MPI over exercise electrocardiography is unclear in individuals attaining a high cardiac workload of ≥10 METS. The purpose of this study was to determine the 1-year outcomes in this cohort at intermediate risk for CAD or with known CAD (11.1%) achieving ≥10 METS regardless of peak exercise heart rate. Methods: Ischemia and LV function were obtained by quantitative gated 99mTc-SPECT MPI in 554 consecutive patients reaching ≥10 METS of exercise workload. One-year rates of all-cause mortality, cardiovascular (CV) death, and non-fatal myocardial infarction (MI) were prospectively-collected through mailed questionnaires, patient and physician telephone contact, patient records, and the social security death index. Results: All-cause mortality and CV death were ascertained in 504 of 554 patients (91.0%) and non-fatal MI in 459 subjects (82.9%). No difference was observe...