Impact of Follow-Up Ischemia on Myocardial Perfusion Single-Photon Emission Computed Tomography in Patients with Coronary Artery Disease
- Authors
- Kang, Se Hun; Choi, Hyo In; Kim, Young-Hak; Lee, Eun Young; Ahn, Jung-Min; Han, Seungbong; Lee, Pil Hyung; Roh, Jae-Hyung; Yun, Sung-Han; Park, Duk-Woo; Kang, Soo-Jin; Lee, Seung-Whan; Lee, Cheol Whan; Moon, Dae Hyuk; Park, Seong-Wook; Park, Seung-Jung
- Issue Date
- Sep-2017
- Publisher
- YONSEI UNIV COLL MEDICINE
- Keywords
- Single-photon emission computerized tomography; prognosis; coronary artery disease
- Citation
- YONSEI MEDICAL JOURNAL, v.58, no.5, pp.934 - 943
- Journal Title
- YONSEI MEDICAL JOURNAL
- Volume
- 58
- Number
- 5
- Start Page
- 934
- End Page
- 943
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/5778
- DOI
- 10.3349/ymj.2017.58.5.934
- ISSN
- 0513-5796
- 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.
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