AIM: TID in the setting of otherwise normal MPI has been suggested as a marker of high risk CAD. In this study we estimate the variance of TID in a normal population and the statistical frequency of false positive TID. This will provide an indirect measurement of predictive accuracy (PA) in a mixed referral population. OBJECTIVE: To study the PA of TID in otherwise normal MPI. METHODS: 688 consecutive patients were studied. We defined TID according to the standard method at 2 cut-off values; 1SD and 2SD, and also by a BSA normalized volume difference with gender-specific 2SD limits (NrVD). RESULTS: 457 patients with otherwise normal MPI were analyzed. PA of TID at 1SD was 4% and 26% at 2SD. PA was slightly higher (42%) using the NrVD, however, still too low to be clinically useful as a high-risk marker. PA of TID in patients with perfusion abnormalities was 58% at 1SD, 80% at 2SD and slightly higher (93%) by NrVD. CONCLUSIONS: In the setting of otherwise normal MPI, elevated TIDr has a low prevalence and poor predictive accuracy and should not be considered summarily as a marker of high risk CAD.
AIM: TID in the setting of otherwise normal MPI has been suggested as a marker of high risk CAD. In this study we estimate the variance of TID in a normal population and the statistical frequency of false positive TID. This will provide an indirect measurement of predictive accuracy (PA) in a mixed referral population. OBJECTIVE: To study the PA of TID in otherwise normal MPI. METHODS: 688 consecutive patients were studied. We defined TID according to the standard method at 2 cut-off values; 1SD and 2SD, and also by a BSA normalized volume difference with gender-specific 2SD limits (NrVD). RESULTS: 457 patients with otherwise normal MPI were analyzed. PA of TID at 1SD was 4% and 26% at 2SD. PA was slightly higher (42%) using the NrVD, however, still too low to be clinically useful as a high-risk marker. PA of TID in patients with perfusion abnormalities was 58% at 1SD, 80% at 2SD and slightly higher (93%) by NrVD. CONCLUSIONS: In the setting of otherwise normal MPI, elevated TIDr has a low prevalence and poor predictive accuracy and should not be considered summarily as a marker of high risk CAD.
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Authors: Lien-Hsin Hu; Tali Sharir; Robert J H Miller; Andrew J Einstein; Mathews B Fish; Terrence D Ruddy; Sharmila Dorbala; Marcelo Di Carli; Philipp A Kaufmann; Albert J Sinusas; Edward J Miller; Timothy M Bateman; Julian Betancur; Guido Germano; Joanna X Liang; Frederic Commandeur; Peyman N Azadani; Heidi Gransar; Yuka Otaki; Balaji K Tamarappoo; Damini Dey; Daniel S Berman; Piotr J Slomka Journal: J Nucl Cardiol Date: 2019-05-13 Impact factor: 5.952