2016-11-29
Ischemia burden on stress SPECT MPI predicts long-term outcomes after revascularization in stable coronary artery disease
Publication
Publication
Journal of Nuclear Cardiology p. 1- 9
Background: It is not entirely clear whether ischemia burden on stress single-photon emission computed tomography (SPECT) effectively identifies patients who have a long-term benefit from coronary revascularization. Methods: The study population consisted of 719 patients with ischemia on stress SPECT. Early coronary revascularization was defined as percutaneous coronary intervention or coronary artery bypass grafting ≤90 days after SPECT. Patients who underwent late revascularization (>90 days after SPECT) were excluded (n = 164). Results: Of the 538 patients (73% men, mean age 59.8 ± 11 years), 348 patients had low ischemia burden (<3 ischemic segments) and 190 patients had moderate to high ischemia burden (≥3 ischemic segments). A total of 76 patients underwent early revascularization. During a median follow-up of 12 years (range 4-17), 283 patients died of whom 125 due to cardiac causes. Early revascularization was beneficial on all-cause mortality (HR 0.46, 95% CI 0.30-0.46) and cardiac mortality (HR 0.54, 95% CI 0.29-0.99). Conclusions: Patients with myocardial ischemia on stress SPECT who underwent early revascularization had a lower all-cause mortality and cardiac mortality during long-term follow-up as compared to patients who received pharmacological therapy alone. This difference in long-term outcomes was mainly influenced by the survival benefit of early revascularization in the patients with moderate to high ischemia burden.
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doi.org/10.1007/s12350-016-0735-5, hdl.handle.net/1765/94628 | |
Journal of Nuclear Cardiology | |
Organisation | Department of Cardiology |
Boiten, H.-J., van den Berge, J., Valkema, R., van Domburg, R.T. (Ron T.), Zijlstra, F., & Schinkel, A. (2016). Ischemia burden on stress SPECT MPI predicts long-term outcomes after revascularization in stable coronary artery disease. Journal of Nuclear Cardiology, 1–9. doi:10.1007/s12350-016-0735-5 |