Multiple Choice Question of the Week : Nuclear-06 : [Answer]


Patients in the DIAD study had a mean follow up of 4.8 ± 0.9 years and the rate of cardiac events was recorded.

In this study which of the following is/are true:

A) Inducible ischemia was shown to be associated with worse cardiac outcomes.
B) High positive predictive value of an abnormal MPI for subsequent cardiac events..
C) Cardiac event rates in this population were on average, 0.6% per year.
D) DIAD patients frequently had worsening of inducible ischemia when re-screened 3 years after randomization.

Correct answer is C)

Overall, cardiac event rates in this population were much lower than anticipated (average, 0.6% per year).

The study concludes the following:
– The yield of detecting significant inducible ischemia is relatively low.
– The overall cardiac event rate is low.
– Routine screening does not appear to affect overall outcome.
– DIAD patients with ischemia on their initial scan had often resolution of ischemia on subsequent scan.

The figure shows an example of myocardial perfusion scintigraphy with inducible ischemia in the LAD territory

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