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Ischemia burden on stress SPECT MPI predicts long-term outcomes after revascularization in stable coronary artery disease

Boiten, Hendrik J. ; van den Berge, Jan C. ; Valkema, Roelf ; van Domburg, Ron T. ; Zijlstra, Felix ; Schinkel, Arend F.L.

Journal of nuclear cardiology, 2018-06, Vol.25 (3), p.958-966 [Periódico revisado por pares]

New York: Elsevier Inc

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Título:
Ischemia burden on stress SPECT MPI predicts long-term outcomes after revascularization in stable coronary artery disease
Autor: Boiten, Hendrik J. ; van den Berge, Jan C. ; Valkema, Roelf ; van Domburg, Ron T. ; Zijlstra, Felix ; Schinkel, Arend F.L.
Assuntos: Aged ; Cardiology ; Cardiovascular disease ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - mortality ; Coronary Artery Disease - surgery ; Coronary vessels ; Early revascularization ; Exercise Test ; Female ; Humans ; Imaging ; Ischemia ; Logistic Models ; long-term ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Myocardial Ischemia - diagnostic imaging ; Myocardial Ischemia - mortality ; Myocardial Ischemia - surgery ; Myocardial Perfusion Imaging ; Myocardial Revascularization ; Nuclear Medicine ; Original Article ; Predictive Value of Tests ; Radiology ; SPECT ; Survival Rate ; Time Factors ; Tomography, Emission-Computed, Single-Photon ; Treatment Outcome
É parte de: Journal of nuclear cardiology, 2018-06, Vol.25 (3), p.958-966
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SourceType-Scholarly Journals-1
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Descrição: It is not entirely clear whether ischemia burden on stress single-photon emission computed tomography (SPECT) effectively identifies patients who have a long-term benefit from coronary revascularization. The study population consisted of 719 patients with ischemia on stress SPECT. Early coronary revascularization was defined as percutaneous coronary intervention or coronary artery bypass grafting ≤90 days after SPECT. Patients who underwent late revascularization (>90 days after SPECT) were excluded (n = 164). Of the 538 patients (73% men, mean age 59.8 ± 11 years), 348 patients had low ischemia burden (<3 ischemic segments) and 190 patients had moderate to high ischemia burden (≥3 ischemic segments). A total of 76 patients underwent early revascularization. During a median follow-up of 12 years (range 4-17), 283 patients died of whom 125 due to cardiac causes. Early revascularization was beneficial on all-cause mortality (HR 0.46, 95% CI 0.30-0.46) and cardiac mortality (HR 0.54, 95% CI 0.29-0.99). Patients with myocardial ischemia on stress SPECT who underwent early revascularization had a lower all-cause mortality and cardiac mortality during long-term follow-up as compared to patients who received pharmacological therapy alone. This difference in long-term outcomes was mainly influenced by the survival benefit of early revascularization in the patients with moderate to high ischemia burden.
Editor: New York: Elsevier Inc
Idioma: Inglês

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Ischemia burden on stress SPECT MPI predicts long-term outcomes after revascularization in stable coronary artery disease

Boiten, Hendrik J. ; van den Berge, Jan C. ; Valkema, Roelf ; van Domburg, Ron T. ; Zijlstra, Felix ; Schinkel, Arend F.L.

New York: Elsevier Inc

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