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Impact of Follow-Up Ischemia on Myocardial Perfusion Single-Photon Emission Computed Tomography in Patients with Coronary Artery Disease
Yonsei med. j ; Yonsei med. j;: 934-943, 2017.
Article de En | WPRIM | ID: wpr-26749
Bibliothèque responsable: WPRO
ABSTRACT
PURPOSE: Few studies have reported on predicting prognosis using myocardial perfusion single-photon emission computed tomography (SPECT) during coronary artery disease (CAD) treatment. Therefore, we aimed to assess the clinical implications of myocardial perfusion SPECT during follow-up for CAD treatment. MATERIALS AND METHODS: We enrolled 1153 patients who had abnormal results at index SPECT and underwent follow-up SPECT at intervals ≥6 months. Major adverse cardiac events (MACE) were compared in overall and 346 patient pairs after propensity-score (PS) matching. RESULTS: Abnormal SPECT was associated with a significantly higher risk of MACE in comparison with normal SPECT over the median of 6.3 years (32.3% vs. 19.8%; unadjusted p<0.001). After PS matching, abnormal SPECT posed a higher risk of MACE [32.1% vs. 19.1%; adjusted hazard ratio (HR)=1.73; 95% confidence interval (CI)=1.27–2.34; p<0.001] than normal SPECT. After PS matching, the risk of MACE was still higher in patients with abnormal follow-up SPECT in the revascularization group (30.2% vs. 17.9%; adjusted HR=1.73; 95% CI=1.15–2.59; p=0.008). Low ejection fraction [odds ratio (OR)=5.33; 95% CI=3.39–8.37; p<0.001] and medical treatment (OR=2.68; 95% CI=1.93–3.72; p<0.001) were independent clinical predictors of having an abnormal result on follow-up SPECT. CONCLUSION: Abnormal follow-up SPECT appears to be associated with a high risk of MACE during CAD treatment. Follow-up SPECT may play a potential role in identifying patients at high cardiovascular risk.
Sujet(s)
Mots clés
Texte intégral: 1 Indice: WPRIM Sujet Principal: Perfusion / Pronostic / Maladie des artères coronaires / Tomoscintigraphie / Tomographie par émission monophotonique / Études de suivi / Vaisseaux coronaires / Ischémie Type d'étude: Observational_studies / Prognostic_studies / Risk_factors_studies Limites du sujet: Humans langue: En Texte intégral: Yonsei med. j Année: 2017 Type: Article
Texte intégral: 1 Indice: WPRIM Sujet Principal: Perfusion / Pronostic / Maladie des artères coronaires / Tomoscintigraphie / Tomographie par émission monophotonique / Études de suivi / Vaisseaux coronaires / Ischémie Type d'étude: Observational_studies / Prognostic_studies / Risk_factors_studies Limites du sujet: Humans langue: En Texte intégral: Yonsei med. j Année: 2017 Type: Article