ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2016
Prognostic implications of stress modality on mortality risk and cause of death in patients undergoing office-based SPECT myocardial perfusion imaging.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 41 citations in OpenAlex.
- Impact of change of ischemic burden on the outcomes of ESRD patients awaiting kidney transplantation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Is dyspnea the new angina? The ever-changing profile of patients referred for CAD evaluation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- The prognostic and diagnostic implications of surveillance serial myocardial perfusion imaging in asymptomatic renal transplant candidates.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- The imperative to assess physical function among all patients undergoing stress myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Cardiac imaging for the assessment of patients being evaluated for liver transplantation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Review
- The prognostic implications of ST-segment and T-wave abnormalities in patients undergoing regadenoson stress SPECT myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Beyond traditional cardiovascular risk factors: Could frailty and other morbidities explain the worse prognosis in patients undergoing pharmacologic stress?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Cardiac imaging for the assessment of patients being evaluated for kidney transplantation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Review
- Mortality risk among patients undergoing exercise versus pharmacologic myocardial perfusion imaging: A propensity-based comparison.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- The prognostic value of regadenoson SPECT myocardial perfusion imaging: The largest cohort to date.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- The evolution of the prognostic value of regadenoson SPECT myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Changing Drivers of Mortality Among Patients Referred for Cardiac Stress Testing.Mayo Clinic proceedings. Innovations, quality & outcomes · 2021Article
- Differential Impact of Appropriate Use Criteria on the Association between Age and an Abnormal Stress Myocardial Perfusion SPECT.Cardiovascular innovations and applications · 2019Article
- Stress Echocardiography Positivity Predicts Cancer Death.Journal of the American Heart Association · 2017Observational
- Review of cardiovascular imaging in the journal of nuclear cardiology in 2016: Part 2 of 2-myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Review
- Stress SPECT Myocardial Perfusion Imaging in End-Stage Renal Disease.Current cardiovascular imaging reports · 2017Article
- Comparison of the current reasons for undergoing pharmacologic stress during echocardiographic and radionuclide stress testing.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- Non-invasive assessment of low- and intermediate-risk patients with chest pain.Trends in cardiovascular medicine · 2017Review
- The prognostic value of regadenoson SPECT myocardial perfusion imaging in patients with end-stage renal disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- The role of pharmacological stress testing in women.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Review
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients requiring vasodilator single-photon emission computed-tomography myocardial perfusion imaging (SPECT-MPI) have a higher mortality risk than those selected for exercise or vasodilator with low-level exercise SPECT-MPI. However, it is unknown whether the increased mortality is driven by cardiac deaths alone or cardiac and non-cardiac deaths.
methodsIn a prospective cohort of 1,511 consecutive patients referred for SPECT-MPI, patients were classified according to stress test modality: exercise, adenosine with low-level exercise (AdenoEx), and adenosine. Subjects were followed for events of all-cause mortality and cause of death. Survival analyses using multivariate Cox regression and propensity score matching methods were performed.
resultsDuring a follow-up of 4.9 ± 0.9 years, a total of 68 (4.5%) deaths occurred: 50 non-cardiac and 18 cardiac. The adenosine group had the highest annual mortality (all-cause 3.65%, non-cardiac 2.36%, cardiac 1.29%), while exercise stress had the lowest mortality (all-cause 0.42%, non-cardiac 0.37%, cardiac 0.05%) and AdenoEx had an intermediate mortality (all-cause 1.3%, non-cardiac 0.91%, cardiac 0.39%); all P values <0.001. The majority of non-cardiac deaths were attributed to cancer. Using exercise stress as a reference standard, multivariable Cox regression analyses demonstrated that adenosine stress was independently predictive of all-cause mortality [HR 3.23 (CI 1.77-5.88); P < 0.001], non-cardiac death [HR 2.67 (CI 1.34-5.31); P = 0.005], and cardiac death [HR 6.30 (CI 1.55-25.56); P = 0.010] after adjusting for univariate predictors of mortality. These findings were consistent in the subgroups of patients with normal and abnormal MPI. AdenoEx was predictive of all-cause, non-cardiac, and cardiac deaths in univariate analysis, but it was not predictive by multivariate analysis. Propensity score matched cohort analysis showed that the adenosine stress group had the highest all-cause (P < 0.001), non-cardiac (P = 0.013), and cardiac deaths (P < 0.001), while the exercise stress group had the lowest mortality of any cause.
conclusionsThe inability to perform any level of exercise during a SPECT-MPI stress is associated with high mortality risk, which is derived from both cardiac and non-cardiac deaths.
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