Ejection fraction, ESVI and IS measurements performed one to two weeks after MI can each predict six-month mortality. Ejection fraction was superior to the other two measurements. However, this study had limited power to detect independent significance of ESVI or IS.
Candesartan alone was as effective, safe, and tolerable as enalapril. The combination of candesartan and enalapril was more beneficial for preventing left ventricular remodeling than either candesartan or enalapril alone.
In patients with severe LV dysfunction, the amount of scar was a significant independent predictor of LV function recovery after revascularization. A combination of PET and clinical parameters predicts the degree of recovery. This model is being applied in a large randomized controlled trial to determine the effectiveness of therapy guided by FDG PET.
Objective. Classic risk factors do not fully account for the increased risk of coronary artery disease (CAD) in systemic lupus erythematosus (SLE), making identification of the subset of patients at risk challenging. In this prospective cohort study we investigated whether myocardial perfusion defects in SLE are predictive of CAD events, independently of traditional Framingham risk factors. Methods. We performed myocardial perfusion imaging in 122 women with SLE who did not have a history of CAD. Patients had clinical and serologic evaluation, and an assessment of cardiac risk factors. They were then followed for the occurrence of CAD events. Cox regression models were used to determine independent predictors of CAD. Results. Forty-six (37.7%) patients had perfusion defects. Median followup was 8.7 years, during which 15 CAD events occurred (1 myocardial infarction, 14 angina). Cox modeling showed that myocardial perfusion defects are strongly predictive of CAD [hazard ratio (HR) 13.0, 95% CI 2.8 to 60.1, p = 0.001]. Although the 10-year Framingham risk score was significantly predictive of CAD (HR 1.8, 95% CI 1.1 to 2.9, p = 0.01), the risk scores in groups with normal and abnormal scans were similar to the "low-risk" general population. Conclusion. In women with SLE, myocardial perfusion defects are strongly and independently predictive of CAD. Our findings suggest that myocardial perfusion imaging to assess risk of future coronary events should be considered in women with SLE
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