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- Title
Impact of Follow-Up Ischemia on Myocardial Perfusion Single-Photon Emission Computed Tomography in Patients with Coronary Artery Disease.
- Authors
Se Hun Kang; Hyo In Choi; Young-Hak Kim; Eun Young Lee; Jung-Min Ahn; Seungbong Han; Pil Hyung Lee; Jae-Hyung Roh; Sung-Han Yun; Duk-Woo Park; Soo-Jin Kang; Seung-Whan Lee; Cheol Whan Lee; Dae Hyuk Moon; Seong-Wook Park; Seung-Jung Park
- 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.
- Subjects
SINGLE-photon emission computed tomography; MYOCARDIAL perfusion imaging; CORONARY disease; ISCHEMIA; MYOCARDIAL revascularization; PROGNOSIS
- Publication
Yonsei Medical Journal, 2017, Vol 58, Issue 5, p934
- ISSN
0513-5796
- Publication type
Article
- DOI
10.3349/ymj.2017.58.5.934