Usefulness of Serial Radionuclide Angiography in Predicting Cardiac Death After Coronary Artery Bypass Grafting and Comparison With Clinical and Cardiac Catheterization Data

Borges‐Neto, Salvador; Shaw, Leslee J.; Kesler, Karen; Sell, Timothy L.; Peterson, Eric D.; Coleman, R. Edward; Jones, Robert H.

doi:10.1016/s0002-9149(97)00002-7

Cited by 23 publications

(2 citation statements)

References 15 publications

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“…16,17 Clinical variables included age, gender, race, hypertension, diabetes, history of heart failure, New York Heart Association functional classification, CAD severity as reflected by the number of diseased vessels, prior MI, prior revascularization, peripheral vascular disease, renal insufficiency, smoking history, chronic obstructive pulmonary disease, hyperlipidemia, presence of carotid bruits, ventricular S3 gallop, and a modified Charlson comorbidity index. 18 A history of heart failure and prior MI were removed from Charlson index and examined independently given their established association with SCD.…”

Section: Clinical Informationmentioning

confidence: 99%

Single-Photon Emission Computed Tomography Myocardial Perfusion Defects Are Associated With an Increased Risk of All-Cause Death, Cardiovascular Death, and Sudden Cardiac Death

Piccini

Horton

Shaw

et al. 2008

Circ: Cardiovascular Imaging

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Background— Single-photon emission computed tomography myocardial perfusion imaging defects are associated with increased all-cause mortality and cardiovascular death. However, it is unknown whether single-photon emission computed tomography myocardial perfusion imaging can identify patients at increased risk of sudden cardiac death (SCD). Methods and Results— We analyzed a cohort of 6383 patients with angiographically documented coronary artery disease who underwent single-photon emission computed tomography imaging. Cox proportional hazards modeling was used to examine the relationship between patient characteristics and SCD. Among patients who died, the median time to SCD was 2.7 years (25 th , 75 th percentiles 0.9, 4.9, respectively). The incidence of SCD was 3.4% (n=215) over 6.1 years (25 th , 75 th percentiles 3.7, 9.2, respectively) of follow-up. Patients with SCD had more severe heart failure symptoms, greater comorbidity (Charlson index), and higher summed stress perfusion scores (all P <0.001). After adjusting for left ventricular ejection fraction and other clinical factors in the multivariable model, the summed stress perfusion score (fixed plus reversible defects) remained significantly associated with the occurrence of SCD: summed stress perfusion score (hazard ratios per 3 U: 1.16 [95% CI, 1.08 to 1.25], P <0.001), left ventricular ejection fraction (hazard ratios per 5 U: 0.90 [95% CI, 0.85 to 0.95], P <0.001), and Charlson index (hazard ratios 1.35 [95% CI, 1.23 to 1.49], P <0.001). Conclusions— Myocardial perfusion imaging is a significant predictor of SCD and provides information independent of clinical history and left ventricular ejection fraction. Gated single-photon emission computed tomography imaging, which evaluates both myocardial perfusion and function, may represent a more effective means of risk stratification than solitary left ventricular ejection fraction determination and should be evaluated in prospective trials.

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Section: Clinical Informationmentioning

confidence: 99%

Single-Photon Emission Computed Tomography Myocardial Perfusion Defects Are Associated With an Increased Risk of All-Cause Death, Cardiovascular Death, and Sudden Cardiac Death

Piccini

Horton

Shaw

et al. 2008

Circ: Cardiovascular Imaging

Self Cite

View full text Add to dashboard Cite

show abstract

“…Clinical information. Demographic and clinical characteristics were recorded prospectively at the time of coronary angiography (9,10). Prospectively collected variables included: age, sex, race, LVEF, hypertension, diabetes, history of heart failure, New York Heart Association (NYHA) functional classification, CAD severity as reflected by the number of diseased vessels, prior myocardial infarction, prior revascularization, peripheral vascular disease, renal insufficiency (chronic kidney disease stage Ն3; estimated glomerular filtration rate Ͻ60 ml/min), smoking history, chronic obstructive pulmonary disease, hyperlipidemia, presence of carotid bruits, ventricular S 3 gallop, and a modified Charlson comorbidity index (11).…”

Section: Methodsmentioning

confidence: 99%