Coronary calcium score influences referral for invasive coronary angiography after normal myocardial perfusion SPECT.
J Nucl Cardiol
; 26(2): 602-612, 2019 04.
Article
en En
| MEDLINE
| ID: mdl-28916890
ABSTRACT
BACKGROUND:
In patients with normal SPECT but persistent complaints, invasive angiography may exclude obstructive coronary disease. We assessed whether high coronary artery calcium (CAC) scores are associated with increased referral for invasive angiography following normal SPECT. METHODS ANDRESULTS:
2286 consecutive patients (mean age 60 ± 12, 39% male) with normal SPECT were assessed. All patients underwent simultaneous CAC scoring. Patients were categorized into four groups based on their CAC score CAC = 0 (n = 694), CAC 1 to 100 (n = 891), CAC 101 to 400 (n = 368), and CAC >400 (n = 333). The decision to perform angiography was left to the discretion of treating physician. Follow-up angiography was confined to the first 60 days after SPECT. Occurrence of MACE (late revascularization, myocardial infarction or death) was recorded. Overall, 100 patients (4.4%) underwent early angiography with increasing rates in higher CAC score groups (1.0%, 2.6%, 8.4%, and 11.7%), respectively, P < .001). A CAC score >400 (OR 3.56, 95% CI 2.19 to 5.77, P < .001) was independently associated with referral to angiography. Similarly, CAC score >400 was an independent predictor for MACE (HR 9.26, 95% CI 5.06 to 16.93). Early angiography did not influence prognosis (HR 1.57, 95% CI 0.91 to 2.73).CONCLUSIONS:
CAC scoring impacts clinical decision-making and increases referral rates for invasive angiography after normal SPECT.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Cardiología
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Tomografía Computarizada de Emisión de Fotón Único
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Calcio
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Angiografía Coronaria
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Imagen de Perfusión Miocárdica
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Corazón
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Nucl Cardiol
Asunto de la revista:
CARDIOLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Países Bajos