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Yonsei Med J. 2017 Sep;58(5):934-943. doi: 10.3349/ymj.2017.58.5.934.

Impact of Follow-Up Ischemia on Myocardial Perfusion Single-Photon Emission Computed Tomography in Patients with Coronary Artery Disease.

Author information

1
Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
2
Division of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
3
Division of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. mdyhkim@amc.seoul.kr.
4
Department of Applied Statistics, Gachon University, Seongnam, Korea.
5
Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

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.

KEYWORDS:

Single-photon emission computerized tomography; coronary artery disease; prognosis

PMID:
28792136
PMCID:
PMC5552647
DOI:
10.3349/ymj.2017.58.5.934
[Indexed for MEDLINE]
Free PMC Article

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