Evaluation and influencing factors of early residual myocardial ischemia on myocardial perfusion imaging after percutaneous coronary intervention for coronary artery disease
10.3760/cma.j.cn321828-20230928-00066
- VernacularTitle:基于核素心肌灌注显像评估冠心病PCI术后早期残留心肌缺血及其影响因素
- Author:
Zhimin YANG
1
;
Xiaoyu YANG
;
Yuetao WANG
;
Wenji YU
;
Ke LI
;
Chun QIU
;
Feifei ZHANG
;
Xiao-Liang SHAO
;
Baosheng MENG
;
Jianfeng WANG
Author Information
1. 苏州大学附属第三医院、常州市第一人民医院核医学科、苏州大学核医学与分子影像临床转化研究所，常州 213003
- Keywords:
Coronary disease;
Percutaneous coronary intervention;
Myocardial ischemia;
Myocardial perfusion imaging;
Technetium Tc 99m sestamibi
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2024;44(9):539-544
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate early residual myocardial ischemia after successful percutaneous coronary intervention (PCI) in patients with coronary artery disease by using myocardial perfusion imaging (MPI) and investigate independent influencing factors of early residual myocardial ischemia.Methods:From January 2020 to December 2022, 127 patients (107 males, 20 females; age (60.3±9.6) years) with coronary artery disease who underwent PCI complete revascularization at the First People′s Hospital of Changzhou were consecutively enrolled prospectively. All patients underwent rest and stress MPI within 1-3 months after PCI. Reversible myocardial perfusion defect in the blood supply area of the culprit vessels in stress and rest MPI was defined as early residual myocardial ischemia after PCI. Accordingly, the culprit vessels undergoing PCI were divided into residual ischemic group and non-ischemic group. Differences of cardiovascular examination between two groups were compared ( χ2 test), such as proportion of culprit vessels with severe stenosis (≥90%), proportion of bifurcation lesions, and proportion of diffuse coronary disease. Logistic regression analyses were performed to identify influencing factors for early residual myocardial ischemia. Results:Among 148 culprit vessels undergoing PCI in 127 patients, early residual myocardial ischemia was present in 49 vessels (33.1%, 49/148). The proportion of culprit vessels with severe stenosis before PCI in residual ischemia group was higher than that in non-ischemia group (69.4%(34/49) and 49.5%(49/99); χ2=5.27, P=0.022). The proportion of bifurcation lesions in residual ischemic group was also higher than that in non-ischemic group (28.6%(14/49) and 10.1%(10/99); χ2=8.23, P=0.004), with a slightly higher proportion of diffuse coronary disease compared to non-ischemic group (14.3%(7/49) and 4.0%(4/99); χ2=3.62, P=0.057). Multivariate logistic regression analysis showed that bifurcation lesion (odds ratio ( OR)=4.087, 95% CI: 1.615-10.344, P=0.003) and diffuse coronary disease ( OR=4.208, 95% CI: 1.115-15.878, P=0.034) were independent influencing factors for early residual myocardial ischemia. Conclusions:Early residual myocardial ischemia is still present in about 1/3 of the culprit vessels after PCI complete revascularization. Bifurcation lesion and diffuse coronary disease are independent influencing factors for early residual myocardial ischemia in culprit vessels.
