2015
The influence of clopidogrel on ischemia diagnosed by myocardial perfusion stress testing
Jovin IS, Ebisu KA, Oprea AD, Brandt CA, Natale D, Finta LA, Dziura J, Wackers FJ. The influence of clopidogrel on ischemia diagnosed by myocardial perfusion stress testing. Journal Of Nuclear Cardiology 2015, 23: 773-779. PMID: 26338428, DOI: 10.1007/s12350-015-0268-3.Peer-Reviewed Original ResearchConceptsReversible perfusion defectsOdds ratioPerfusion defectsMyocardial perfusion stress testMyocardial perfusion stress testingStress testStress myocardial perfusion scansMyocardial single photon emissionAdenosine stress testInfluence of clopidogrelLikelihood of ischemiaMyocardial perfusion testingUse of clopidogrelCoronary vascular toneExercise stress testMyocardial perfusion scanMyocardial perfusion imagingSingle photon emissionAdenosine receptor antagonistDiagnosis of ischemiaPerfusion scanPerfusion testingVascular toneReceptor antagonistTomography scan
2012
The heart rate response to adenosine: A simple predictor of adverse cardiac outcomes in asymptomatic patients with type 2 diabetes
Hage FG, Wackers FJ, Bansal S, Chyun DA, Young LH, Inzucchi SE, Iskandrian AE. The heart rate response to adenosine: A simple predictor of adverse cardiac outcomes in asymptomatic patients with type 2 diabetes. International Journal Of Cardiology 2012, 167: 2952-2957. PMID: 22981277, PMCID: PMC3723723, DOI: 10.1016/j.ijcard.2012.08.011.Peer-Reviewed Original ResearchConceptsAbnormal myocardial perfusion imagingMyocardial perfusion imagingHeart rate responseCardiac eventsMPI abnormalitiesAsymptomatic patientsAdenosine myocardial perfusion imagingHard cardiac event rateCardiovascular risk factor managementCox proportional regression modelType 2 diabetes mellitusAsymptomatic Diabetics (DIAD) studyCardiac event rateNonfatal myocardial infarctionCardiac autonomic neuropathyRate responseRisk factor managementYears of followAdverse cardiac outcomesProportional regression modelHigh cardiac riskType 2 diabetesDetection of ischemiaAbnormal HRRAutonomic neuropathyGender-based divergence of cardiovascular outcomes in asymptomatic patients with type 2 diabetes: Results from the DIAD study
Tandon S, Wackers F, Inzucchi SE, Bansal S, Staib LH, Chyun DA, Davey JA, Young LH. Gender-based divergence of cardiovascular outcomes in asymptomatic patients with type 2 diabetes: Results from the DIAD study. Diabetes And Vascular Disease Research 2012, 9: 124-130. PMID: 22228772, DOI: 10.1177/1479164111431470.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsymptomatic DiseasesCanadaCardiovascular DiseasesDiabetes ComplicationsDiabetes Mellitus, Type 2FemaleHumansIncidenceKaplan-Meier EstimateMaleMass ScreeningMiddle AgedMyocardial Perfusion ImagingPredictive Value of TestsPrognosisProspective StudiesRisk AssessmentRisk FactorsSex FactorsTime FactorsUnited StatesConceptsType 2 diabetesMyocardial perfusion imagingCardiovascular outcomesStress myocardial perfusion imagingAsymptomatic Diabetics (DIAD) studyBetter cardiac outcomesHigh-risk womenCoronary artery diseaseHigh-risk menDetection of ischemiaMPI abnormalitiesAsymptomatic patientsAsymptomatic menCardiac eventsCardiac outcomesArtery diseaseAsymptomatic womenAbnormal screeningDiabetic studyPerfusion imagingDIAD studyWomenMenDiabetesOutcomes
2009
Cardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes : The DIAD Study: A Randomized Controlled Trial
Young LH, Wackers FJ, Chyun DA, Davey JA, Barrett EJ, Taillefer R, Heller GV, Iskandrian AE, Wittlin SD, Filipchuk N, Ratner RE, Inzucchi SE, Investigators F. Cardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes : The DIAD Study: A Randomized Controlled Trial. JAMA 2009, 301: 1547-1555. PMID: 19366774, PMCID: PMC2895332, DOI: 10.1001/jama.2009.476.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseType 2 diabetesNonfatal myocardial infarctionAsymptomatic coronary artery diseaseMyocardial perfusion imagingCardiac event rateMyocardial infarctionCardiac deathMPI defectsCardiac outcomesEvent ratesScreened groupArtery diseaseSymptoms of CADRadionuclide myocardial perfusion imagingAsymptomatic Diabetics (DIAD) studyHigh cardiac riskLow event ratesPositive predictive valueDetection of ischemiaPrimary medical preventionCoronary revascularizationDiabetes clinicIdentifies patientsControlled Trials
2008
Different manifestations of coronary artery disease by stress SPECT myocardial perfusion imaging, coronary calcium scoring, and multislice CT coronary angiography in asymptomatic patients with type 2 diabetes mellitus
Scholte A, Schuijf J, Kharagjitsingh A, Dibbets-Schneider P, Stokkel M, Jukema J, van der Wall E, Bax J, Wackers F. Different manifestations of coronary artery disease by stress SPECT myocardial perfusion imaging, coronary calcium scoring, and multislice CT coronary angiography in asymptomatic patients with type 2 diabetes mellitus. Journal Of Nuclear Cardiology 2008, 15: 503-509. PMID: 18674717, DOI: 10.1016/j.nuclcard.2008.02.015.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCalcinosisComorbidityCoronary Artery DiseaseDiabetes Mellitus, Type 2FemaleHumansIncidenceMaleMiddle AgedNetherlandsReproducibility of ResultsRisk AssessmentRisk FactorsSensitivity and SpecificityTomography, Emission-Computed, Single-PhotonTomography, X-Ray ComputedVentricular Dysfunction, LeftConceptsType 2 diabetes mellitusCoronary artery diseaseMSCT coronary angiographyAsymptomatic patientsCoronary angiographyDiabetes mellitusPositive CAC scoreMyocardial perfusion imagingCAC scoreCoronary atherosclerosisArtery diseaseCAC scoringCalcium scoringPerfusion imagingAbnormal diagnostic test resultsSilent coronary artery diseaseStress single-photon emissionCoronary artery calcium scoringMultislice CT coronary angiographyTomography myocardial perfusion imagingStress SPECT myocardial perfusion imagingSilent coronary atherosclerosisSPECT myocardial perfusion imagingRelative prognostic valueTomographic coronary angiography
2006
Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging
Papaioannou GI, Kasapis C, Seip RL, Grey NJ, Katten D, Wackers FJ, Inzucchi SE, Engel S, Taylor A, Young LH, Chyun DA, Davey JA, Iskandrian AE, Ratner RE, Robinson EC, Carolan S, Heller GV. Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging. Journal Of Nuclear Cardiology 2006, 13: 362-368. PMID: 16750781, DOI: 10.1016/j.nuclcard.2006.01.022.Peer-Reviewed Original ResearchConceptsEndothelium-dependent vasodilationEndothelium-independent vasodilationCoronary artery diseaseMyocardial perfusion imagingRelative myocardial ischemiaAsymptomatic patientsEndothelial functionNegative predictive valueMyocardial ischemiaAsymptomatic type 2 diabetic patientsExclusion of CADPredictive valueAdenosine myocardial perfusion imagingPeripheral vascular endothelial functionType 2 diabetic patientsType 2 diabetes mellitusHigh negative predictive valueAsymptomatic Diabetics (DIAD) studyBrachial artery ultrasonographyVascular endothelial functionDetection of ischemiaEDV responseRelative ischemiaEndothelial dysfunctionOvert atherosclerosisScreening of asymptomatic patients with type 2 diabetes mellitus for silent coronary artery disease: Combined use of stress myocardial perfusion imaging and coronary calcium scoring
Scholte A, Bax J, Wackers F. Screening of asymptomatic patients with type 2 diabetes mellitus for silent coronary artery disease: Combined use of stress myocardial perfusion imaging and coronary calcium scoring. Journal Of Nuclear Cardiology 2006, 13: 11-18. PMID: 16464712, DOI: 10.1016/j.nuclcard.2005.11.002.Peer-Reviewed Original ResearchMeSH KeywordsAlgorithmsCalcinosisComorbidityCoronary Artery DiseaseDiabetes Mellitus, Type 2Diagnosis, Computer-AssistedExercise TestHumansIncidenceMass ScreeningPrognosisRadionuclide ImagingReproducibility of ResultsRisk AssessmentRisk FactorsSensitivity and SpecificitySurvival RateVentricular Dysfunction, LeftConceptsSilent coronary artery diseaseCoronary artery diseaseCoronary calcium scoringType 2 diabetes mellitusMyocardial perfusion imagingArtery diseaseDiabetes mellitusCalcium scoringPerfusion imagingAsymptomatic individualsStress myocardial perfusion imagingRadionuclide myocardial perfusion imagingEarly appropriate treatmentRecent prospective studiesRates of morbidityAsymptomatic patientsCardiovascular complicationsProspective studyOverall prevalenceClinical combinationAppropriate treatmentClinical investigationMellitusClinical importanceDisease
2004
Randomized, Controlled Dose-Ranging Study of the Selective Adenosine A2A Receptor Agonist Binodenoson for Pharmacological Stress as an Adjunct to Myocardial Perfusion Imaging
Udelson J, Heller G, Wackers F, Chai A, Hinchman D, Coleman P, Dilsizian V, DiCarli M, Hachamovitch R, Johnson J, Barrett R, Gibbons R. Randomized, Controlled Dose-Ranging Study of the Selective Adenosine A2A Receptor Agonist Binodenoson for Pharmacological Stress as an Adjunct to Myocardial Perfusion Imaging. Circulation 2004, 109: 457-464. PMID: 14734517, DOI: 10.1161/01.cir.0000114523.03312.7d.Peer-Reviewed Original ResearchConceptsReversible perfusion defectsDose-related reductionAdenosine receptor stimulationSide effectsPharmacological stressPerfusion defectsReceptor stimulationFrequent side effectsSubjective side effectsDose-Ranging StudyMyocardial perfusion imagingAdenosine A2A receptorsSingle photon emissionChest painCoronary vasodilationCrossover trialBinodenosonA2A receptorsPerfusion imagingSelective agonismRandom orderSeverityKappa valuesSimilar degreePhoton emissionPlanar Myocardial Perfusion Imaging Acquisition and Processing Protocols
Wackers F, Bruni W, Zaret B. Planar Myocardial Perfusion Imaging Acquisition and Processing Protocols. Contemporary Cardiology 2004, 73-80. DOI: 10.1007/978-1-59259-426-9_7.Peer-Reviewed Original Research
2003
Use of radionuclide imaging in acute coronary syndromes
Abbott B, Wackers F. Use of radionuclide imaging in acute coronary syndromes. Current Cardiology Reports 2003, 5: 25-31. PMID: 12493157, DOI: 10.1007/s11886-003-0034-z.Peer-Reviewed Original ResearchConceptsAcute coronary syndromeMyocardial infarctionChest painCoronary syndromeEmergency departmentPerfusion imagingRadionuclide myocardial perfusion imagingAcute chest painTriage of patientsAcute myocardial infarctionPerfusion imaging studyMyocardial perfusion imagingNegative predictive valueReperfusion therapyED evaluationRoutine careRandomized trialsRisk stratificationInfarct sizePrognostic valueDiagnostic challengeUnnecessary hospitalizationPredictive valueTesting modalitiesImaging studiesPrognostic significance of ischemic electrocardiographic changes during adenosine infusion in patients with normal myocardial perfusion imaging
Abbott B, Afshar M, Berger A, Wackers F. Prognostic significance of ischemic electrocardiographic changes during adenosine infusion in patients with normal myocardial perfusion imaging. Journal Of Nuclear Cardiology 2003, 10: 9-16. PMID: 12569326, DOI: 10.1067/mnc.2002.127625.Peer-Reviewed Original ResearchConceptsNormal myocardial perfusion imagingAdenosine myocardial perfusion imagingST-segment depressionMyocardial perfusion imagingIschemic ECG changesCardiac eventsECG changesAdenosine infusionCardiac deathPrognostic significanceECG groupNormal myocardial perfusion imagesBaseline electrocardiographic abnormalitiesAdverse cardiac eventsIschemic electrocardiographic changesNonfatal myocardial infarctionSubsequent cardiac eventsFuture cardiac eventsNormal myocardial perfusionSex-matched groupPerfusion imagesECG evidenceElectrocardiographic abnormalitiesIndependent predictorsElectrocardiographic changes
2002
Pharmacologic stress perfusion imaging with adenosine: Role of simultaneous low-level treadmill exercise
Samady H, Wackers FJ, Joska TM, Zaret BL, Jain D. Pharmacologic stress perfusion imaging with adenosine: Role of simultaneous low-level treadmill exercise. Journal Of Nuclear Cardiology 2002, 9: 188-196. PMID: 11986564, DOI: 10.1067/mnc.2002.119973.Peer-Reviewed Original ResearchConceptsLow-level treadmill exerciseMyocardial perfusion imagingTreadmill exerciseElectrocardiographic changesAdverse effectsAdenosine myocardial perfusion imagingSestamibi single-photon emissionPharmacologic stress myocardial perfusion imagingStress myocardial perfusion imagingIschemic electrocardiographic changesLow-level exerciseMore adverse effectsUnfavorable side effectsSingle photon emissionAdenosine studyAdenosine TcMore patientsMyocardial ischemiaHemodynamic responseStress perfusionSide effectsPerfusion imagingTracer uptakePatientsMPI studies
2001
Selective use of single-photon emission computed tomography myocardial perfusion imaging in a chest pain center
Abbott B, Abdel-Aziz I, Nagula S, Monico E, Schriver J, Wackers F. Selective use of single-photon emission computed tomography myocardial perfusion imaging in a chest pain center. The American Journal Of Cardiology 2001, 87: 1351-1355. PMID: 11397352, DOI: 10.1016/s0002-9149(01)01551-x.Peer-Reviewed Original ResearchConceptsChest pain centerChest pain patientsCoronary artery diseasePain patientsSingle photon emissionChest painPain centerArtery diseaseMyocardial infarctionEmergency department chest pain centersEmergency department chest pain patientsTomography myocardial perfusion imagingTomography myocardial perfusionAcute myocardial infarctionMyocardial perfusion imagingSelective useCPC patientsNonischemic electrocardiogramHospital dischargeAppropriate patientsHospital admissionFinal diagnosisMyocardial perfusionPatientsPerfusion imaging
2000
Association of patients’ perception of health status and exercise electrocardiogram, myocardial perfusion imaging, and ventricular function measures
Mattera J, de Leon C, Wackers F, Williams C, Wang Y, Krumholz H. Association of patients’ perception of health status and exercise electrocardiogram, myocardial perfusion imaging, and ventricular function measures. American Heart Journal 2000, 140: 409-418. PMID: 10966538, DOI: 10.1067/mhj.2000.108518.Peer-Reviewed Original ResearchConceptsGeneral health perceptionHealth-related qualityPhysical functioningHealth perceptionMyocardial perfusion imagingHealth statusExercise testingPerfusion imagingMedical Outcomes Study Short Form SurveyPatients' health-related qualityShort Form SurveyAssociation of patientGeneral health statusImportant outcome measureSuccess of treatmentConsecutive patientsSF-36Metabolic equivalentsNoninvasive testingExercise testPatient outcomesIndividual patientsOutcome measuresForm SurveyPatient's viewpointAn economic analysis of an aggressive diagnostic strategy with single photon emission computed tomography myocardial perfusion imaging and early exercise stress testing in emergency department patients who present with chest pain but nondiagnostic electrocardiograms: Results from a randomized trial
Stowers S, Eisenstein E, Wackers F, Berman D, Blackshear J, Jones A, Szymanski T, Lam L, Simons T, Natale D, Paige K, Wagner G. An economic analysis of an aggressive diagnostic strategy with single photon emission computed tomography myocardial perfusion imaging and early exercise stress testing in emergency department patients who present with chest pain but nondiagnostic electrocardiograms: Results from a randomized trial. Annals Of Emergency Medicine 2000, 35: 17-25. PMID: 28140201, DOI: 10.1016/s0196-0644(00)70100-4.Peer-Reviewed Original ResearchMeSH KeywordsAgedChest PainClinical ProtocolsCoronary AngiographyCost ControlElectrocardiographyEmergency TreatmentExercise TestFemaleHospital CostsHumansLength of StayMaleMedicareMiddle AgedMyocardial InfarctionReproducibility of ResultsRisk FactorsSingle-Blind MethodTomography, Emission-Computed, Single-PhotonUnited StatesConceptsEarly exercise stress testingExercise stress testingLength of stayChest painHospital costsSingle photon emissionCoronary angiographyStress testingDiagnostic strategiesTomography myocardial perfusion imagingCost/charge ratiosAggressive diagnostic strategyNegative scan resultsPositive scan resultsAcute chest painIntermediate-risk patientsAcute coronary syndromeExercise treadmill testingAdverse clinical outcomesShorter median lengthEmergency department patientsAcute myocardial infarctionScan resultsMyocardial perfusion imagingPhoton emission
1998
Exercise testing with myocardial perfusion imaging in patients with normal baseline electrocardiograms: Cost savings with a stepwise diagnostic strategy
Mattera J, Arain S, Sinusas A, Finta L, Wackers F. Exercise testing with myocardial perfusion imaging in patients with normal baseline electrocardiograms: Cost savings with a stepwise diagnostic strategy. Journal Of Nuclear Cardiology 1998, 5: 498-506. PMID: 9796897, DOI: 10.1016/s1071-3581(98)90181-7.Peer-Reviewed Original ResearchConceptsExercise myocardial perfusion imagingCoronary artery diseaseNormal exercise electrocardiogramMyocardial perfusion imagingNormal myocardial perfusion imagingNormal resting electrocardiogramsExercise electrocardiogramExercise testingArtery diseaseIntermediate likelihoodResting electrocardiogramsAbnormal myocardial perfusion imagingDiagnostic strategiesAbnormal exercise electrocardiogramGroup 3 patientsHard cardiac eventsNonfatal myocardial infarctionNormal baseline electrocardiogramSubsequent coronary revascularizationIncremental diagnostic informationDiagnostic testing strategiesCoronary revascularizationCardiac eventsUnstable anginaConsecutive patients
1997
Relationship of scar and ischemia to the results of programmed electrophysiological stimulation in patients with coronary artery disease
Gradel C, Jain D, Batsford W, Wackers F, Zaret B. Relationship of scar and ischemia to the results of programmed electrophysiological stimulation in patients with coronary artery disease. Journal Of Nuclear Cardiology 1997, 4: 379-386. PMID: 9362014, DOI: 10.1016/s1071-3581(97)90029-5.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseMyocardial perfusion imagingSustained ventricular tachycardiaPerfusion defect sizeVentricular tachycardiaElectrophysiological studiesArtery diseaseIndependent predictorsMultivariate analysisChronic coronary artery diseaseLeft ventricular ejection fractionSustained monomorphic ventricular tachycardiaGlobal left ventricular functionVentricular ejection fractionLeft ventricular functionPrevious myocardial infarctionMonomorphic ventricular tachycardiaBest independent predictorSize of ischemiaAdditional ischemiaArrhythmia historyInducible patientsNoninducible patientsSize of scarClinical predictors
1996
Diagnostic utility of tomographic myocardial perfusion imaging with technetium 99m furifosmin (Q12) compared with thallium 201: Results of a phase III multicenter trial
Hendel R, Verani M, Miller D, Wackers F, McMahon M, Cerqueira M, Botvinick E, Kvols L, Gerson M. Diagnostic utility of tomographic myocardial perfusion imaging with technetium 99m furifosmin (Q12) compared with thallium 201: Results of a phase III multicenter trial. Journal Of Nuclear Cardiology 1996, 3: 291-300. PMID: 8799247, DOI: 10.1016/s1071-3581(96)90088-4.Peer-Reviewed Original ResearchConceptsMyocardial perfusion agentPerfusion agentMulticenter trialNormalcy ratePhase III multicenter trialCoronary artery diseaseTomographic myocardial perfusionMyocardial perfusion imagingPanel of readersNew myocardial perfusion agentNew perfusion tracerPeak exerciseArtery diseaseThallium scintigraphyPerfusion scintigraphyMyocardial scintigraphyExercise workloadStudy groupLaboratory alterationsMyocardial perfusionThallium-201Perfusion imagingDiagnostic utilityScintigraphyPerfusion studiesPrognostic value of noninvasive testing one year after orthotopic cardiac transplantation
Verhoeven P, Lee F, Ramahi T, Franco K, de Leon C, Amatruda J, Gorham N, Mattera J, Wackers F. Prognostic value of noninvasive testing one year after orthotopic cardiac transplantation. Journal Of The American College Of Cardiology 1996, 28: 183-189. PMID: 8752812, DOI: 10.1016/0735-1097(96)00094-0.Peer-Reviewed Original ResearchConceptsCoronary artery vasculopathyOrthotopic cardiac transplantationCardiac transplantationEquilibrium radionuclide angiographyPrognostic valueRadionuclide angiographyClinical variablesNoninvasive testingHuman leukocyte antigen mismatchesStress thallium-201 imagingThallium-201 myocardial perfusion imagingConsecutive transplant recipientsRoutine noninvasive testingStress myocardial imagingCold ischemic timeStress myocardial perfusionThallium-201 imagingTwo-dimensional echocardiographyNoninvasive diagnostic testingMyocardial perfusion imagingOnly significant predictorAntigen mismatchesLate deathsTransplant recipientsIschemic time
1995
Myocardial perfusion imaging with 99mTc tetrofosmin. Comparison to 201Tl imaging and coronary angiography in a phase III multicenter trial. Tetrofosmin International Trial Study Group.
Zaret B, Rigo P, Wackers F, Hendel R, Braat S, Iskandrian A, Sridhara B, Jain D, Itti R, Serafini A, Goris M, Lahiri A. Myocardial perfusion imaging with 99mTc tetrofosmin. Comparison to 201Tl imaging and coronary angiography in a phase III multicenter trial. Tetrofosmin International Trial Study Group. Circulation 1995, 91: 313-9. PMID: 7805233, DOI: 10.1161/01.cir.91.2.313.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseArtery diseaseTetrofosmin imagingCoronary angiographyMyocardial perfusionTetrofosmin imagesHealthy subjectsPhase III multicenter trialConventional myocardial perfusionLower likelihoodCentral core laboratoryMyocardial perfusion abnormalitiesNew 99mTcPeak heart rateNegative predictive accuracyMyocardial perfusion imagingNew myocardial imaging agentPlanar 201TlMulticenter trialNormalcy rateCoronary angiogramDouble productPerfusion abnormalitiesMyocardial imaging agentRadiotracer injection