Prognostic value of technetium-99m-labeled single-photon emission computerized tomography in the follow-up of patients after their first myocardial revascularization surgery

Santos, Márcia Maria Sales dos; Cwajg, Eduardo; Pantoja, Mauricio da Rocha

doi:10.1590/s0066-782x2003000100003

Cited by 2 publications

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References 8 publications

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“…There are several studies that have shown that the SPECT MPI cardiac stress test can predict early 18,19 and late 20,21 coronary revascularization. Similarly in our study, patients with a positive stress test (SDS > 0) were more likely to have subsequent (post-stress test) coronary revascularization despite adjustment for all reliable predictors identified by bootstrapping methods in addition to history of (pre-stress test) coronary and lower extremity arterial intervention.…”

Section: Discussionmentioning

confidence: 99%

The association between ischemic and jeopardized myocardia and all-cause mortality in patients with peripheral artery disease

et al. 2016

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Peripheral artery disease (PAD) is associated with increased mortality and concomitant coronary artery disease (CAD). However, it is unclear whether uncovering the presence of functional coronary ischemia by single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) would further help stratifying that excess risk. From January 2000 to 2009, 4294 individuals underwent cardiac stress testing within 180 days of ankle-brachial index (ABI) measurements. Of these, 645 had PAD and SPECT MPI stress testing. Abnormal ABI was defined as ⩽ 0.9 or prior lower extremity arterial revascularization. Myocardial ischemic burden and total jeopardized myocardium were represented by the summed difference score (SDS) and summed stress score (SSS), respectively. Univariate and multivariable Cox proportional hazard analyses were used to study the impact of SDS and SSS on all-cause mortality. Additionally, using a hierarchical approach, we examined the step-wise addition of post-stress test coronary and lower extremity arterial revascularizations as time-varying covariates on outcomes. We found no significant difference in all-cause mortality between patients with ischemic myocardium (SDS > 0) and those without (SDS = 0) (adjusted HR: 0.94, 95% CI: 0.53-1.69; p = 0.84). Similarly, the presence of jeopardized myocardium (SSS > 0) did not have a significant impact on mortality (adjusted HR: 1.16, 95% CI: 0.67-2.00; p = 0.59). Moreover, adjustment for post-testing coronary and lower extremity arterial revascularizations did not affect our results. In conclusion, ischemic and jeopardized myocardia are not predictors of all-cause mortality in PAD; thus, SPECT MPI does not appear to be a useful risk stratification tool in these patients.

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