ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2016
Prognostic impact of location and extent of vessel-related ischemia at myocardial perfusion scintigraphy in patients with or at risk for coronary artery disease.
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. An erratum has been issued. Cited by 11 papers.
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11 citing papers in PubMed, 26 citations in OpenAlex.
- Comparative analysis between myocardial perfusion reserve and maximal ischemia score at single photon emission computed tomography with new-generation cadmium-zinc-telluride cameras.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Observational
- Myocardial-coronary fusion imaging with positron emission tomography and computed tomography: Benchmarking and slingshotting.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
- Hybrid anatomo-functional imaging of coronary artery disease: Beneficial irrespective of its core components.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Review
- Prognostic accuracy of myocardial perfusion imaging in octogenarians.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Bridging the Atlantic gap in clinical guidelines for non-ST-elevation acute coronary syndromes.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Impact of coronary revascularization vs medical therapy on ischemia among stable patients with or suspected coronary artery disease undergoing serial myocardial perfusion scintigraphy.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- 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
- Intracoronary pressure measurement differences between anterior and posterior coronary territories.Herz · 2017Article
- Real-world use of fractional flow reserve in Germany: results of the prospective ALKK coronary angiography and PCI registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2017Article
- Review of Cardiovascular Imaging in the Journal of Nuclear Cardiology in 2015-Part 2 of 2: Myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Article
- Prognostic significance of ischemia location on stress myocardial perfusion SPECT: Tracing the fingerprints of the widow maker.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMyocardial perfusion scintigraphy (MPS) has an established diagnostic and prognostic role in patients with or at risk for coronary artery disease, with ischemia severity and extent having already been identified as key predictors. Whether this is affected by the location of myocardial ischemia is uncertain. We aimed at comparing the prognostic outlook of patients undergoing MPS according to the site of ischemia.
methodsOur institutional database was queried for subjects undergoing MPS, without myocardial necrosis or recent revascularization. We focused on the prognostic impact of location of vessel-related ischemia (VRI) at MPS, distinguishing four mutually exclusive groups: single-VRI involving left anterior descending (LAD), single-VRI not involving LAD, multi-VRI involving LAD, and multi-VRI not involving LAD. The primary outcome was the long-term (>1 year) rate of death or myocardial infarction (D/MI).
resultsA total of 13,254 patients were included. Moderate or severe VRI occurred in 2,627 (20%) patients. Clinical outcomes were significantly different among the groups of patients with moderate or severe VRI, including death, cardiac death, non-fatal myocardial infarction or their composites (overall P < .001). Specifically, and excluding subjects undergoing revascularization as first follow-up event, D/MI occurred in 8.4% of patients with single-VRI involving LAD, 5.5% of subjects with single-VRI not involving LAD, 16.5% of those with multi-VRI involving LAD, and 7.3% of patients with multi-VRI not involving LAD (overall P < .001). Even at incremental multivariable Cox proportional analysis, hierarchical VRI was independently associated with an increased risk of D/MI [hazard ratio = 1.17 (1.04-1.08) for each class increment, P = .010].
conclusionsLocation and extent of myocardial ischemia at MPS according to the VRI concept have a hierarchical predictive impact, with multi-VRI involving LAD being significantly and independently more prognostically ominous than other types of VRI.
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