ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2017
Impact of coronary revascularization vs medical therapy on ischemia among stable patients with or suspected coronary artery disease undergoing serial myocardial perfusion scintigraphy.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Comparison of mid- to long-term clinical outcomes between anatomical testing and usual care in patients with suspected coronary artery disease: A meta-analysis of randomized trials.Clinical cardiology · 2017Pooled it
- Myocardial perfusion imaging prior to coronary revascularization: From risk stratification to procedure guidance.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Comparison of CZT SPECT and conventional SPECT for assessment of contractile function, mechanical synchrony and myocardial scar in patients with heart failure.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Stable but Progressive Nature of Heart Failure: Considerations for Primary Care Physicians.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2018Review
- Review of cardiovascular imaging in the Journal of Nuclear Cardiology in 2017. Part 2 of 2: Myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Review
- The Significance of Thallium-201-Chloride SPECT Myocardial Perfusion Imaging in the Management of Patients With Stable Chronic Coronary Artery Disease.Clinical Medicine Insights. Cardiology · 2018Article
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Authors and funding
13 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRandomized trials have challenged the role of revascularization in stable coronary artery disease. We aimed to appraise the impact of revascularization on ischemia in patients undergoing serial myocardial perfusion scintigraphy (MPS).
methodsWe queried our institutional database for stable subjects undergoing serial MPS and appraised the impact of revascularization on changes in ischemia.
resultsA total of 3631 patients were included: 967 (27%) undergoing revascularization and 2664 (73%) receiving medical therapy only. Patients treated with revascularization had a significantly lower burden of myocardial ischemia at follow-up (odds ratio = 0.577 [95% confidence interval 0.483-0.689] vs medical therapy, P < .001). Among all those having moderate or severe ischemia at baseline, revascularization was associated with a follow-up prevalence of 80% for no, minimal, or mild ischemia and 20% for moderate or severe ischemia, vs 43% and 57% for medical therapy (P < .001). Even at multivariable analysis and propensity-adjusted, and propensity-matched analyses, revascularization was associated with a significantly lower prevalence of moderate or severe ischemia at follow-up (respectively P < .001, P = .001, and P = .042).
conclusionsRevascularization appears superior to medical therapy in reducing ischemic burden and normalizing myocardial perfusion among subjects with moderate or severe ischemia at baseline.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.