The prognostic value of myocardial perfusion imaging (MPI) with the cadmium-zinc-telluride (CZT) SPECT camera is not well established. Therefore, the aim of the current study was to evaluate the prognostic value of MPI performed with a CZT SPECT camera in a large cohort of patients suspected of having coronary artery disease. Methods: Consecutive symptomatic stable patients (n = 4,057) without a history of coronary artery disease underwent CZT SPECT MPI. During a median follow-up of 2.4 y (25th–75th percentile, 1.7–3.4), patients were monitored for primary (nonfatal myocardial infarction and cardiac mortality) and secondary outcomes (late revascularization [>90 d after scanning] and primary outcome). Results: Patients with normal perfusion demonstrated low annual event rates (primary outcome, 0.2%; secondary outcome, 0.6%). Annual event rates increased with the extent of abnormality of myocardial perfusion. In patients with small ischemic perfusion defects, annual event rates were 0.7% and 2.8% for the primary and secondary outcome, respectively. In patients with moderate or large ischemic perfusion defects, these event rates were 1.2% and 4.3%, respectively. After multivariate analysis, the risk for events was significantly associated with the extent of ischemia (hazard ratio for small ischemic defects: 2.2, 95% confidence interval [CI], 0.9–5.9 and 4.6, 95% CI, 2.8–7.6, for primary and secondary outcomes, respectively; hazard ratio for moderate or large ischemic defects: 4.0, 95% CI, 1.5–10.5 and 12.1, 95% CI, 7.2–20.2, for primary and secondary outcomes, respectively). Conclusion: Our findings show that MPI acquired with a CZT SPECT camera provides excellent prognostic information, with low event rates in patients with normal myocardial perfusion. In patients with abnormal SPECT MPI, the extent of abnormality is independently associated with an increased risk of events.

镉锌碲化物（CZT）SPECT摄像机对心肌灌注成像（MPI）的预后价值尚不明确。因此，本研究的目的是评估使用CZT SPECT相机进行的MPI对一大批怀疑患有冠心病的患者的预后价值。方法：连续无症状，无冠心病史的症状稳定患者（n = 4,057）接受CZT SPECT MPI治疗。在2.4年的中位随访期间（25-75％，1.7-3.4），监测患者的主要（非致命性心肌梗塞和心脏死亡率）和次要结局（晚期血运重建[扫描后> 90 d]和主要结局） 。结果：灌注正常的患者年事件发生率较低（主要结局为0.2％；次要结局为0.6％）。年度事件发生率随着心肌灌注异常程度的增加而增加。在缺血性灌注缺损较小的患者中，主要和次要结局的年事件发生率分别为0.7％和2.8％。在患有中度或大型缺血性灌注缺损的患者中，这些事件的发生率分别为1.2％和4.3％。经过多因素分析后，发生事件的风险与局部缺血的程度显着相关（对于小型局部缺血缺损的危险比：原发性2.2、95％置信区间[CI]，0.9-5.9和4.6、95％CI，2.8-7.6）和次要结果；分别为中度或大型缺血性缺损的危险比：4.0、95％CI，1.5-10.5和12.1、95％CI，7.2-20.2，结论：我们的研究结果表明，使用CZT SPECT摄像机采集的MPI可提供出色的预后信息，对正常心肌灌注患者的事件发生率较低。在SPECT MPI异常的患者中，异常的程度与发生事件的风险增加独立相关。