Impact of Follow-Up Ischemia on Myocardial Perfusion Single-Photon Emission Computed Tomography in Patients with Coronary Artery Disease.
10.3349/ymj.2017.58.5.934
- Author:
Se Hun KANG
1
;
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
Author Information
1. Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
- Publication Type:Original Article
- Keywords:
Single-photon emission computerized tomography;
prognosis;
coronary artery disease
- MeSH:
Coronary Artery Disease*;
Coronary Vessels*;
Follow-Up Studies*;
Humans;
Ischemia*;
Perfusion*;
Prognosis;
Tomography, Emission-Computed*;
Tomography, Emission-Computed, Single-Photon
- From:Yonsei Medical Journal
2017;58(5):934-943
- CountryRepublic of Korea
- Language:English
-
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.
