Observational studyJournal of the American College of Cardiology2019
Extent of Myocardial Ischemia on Positron Emission Tomography and Survival Benefit With Early Revascularization.
Observational study in Journal of the American College of Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
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Who cites it
38 citing papers in PubMed.
- Multicenter evaluation of interpretable AI for coronary artery disease diagnosis from PET biomarkers.NPJ digital medicine · 2026Article
- Real-world effectiveness of early revascularization in stable coronary artery disease with moderate or severe ischemia.American heart journal plus : cardiology research and practice · 2025Article
- What role for cardiac imaging in chronic coronary syndromes: review of the literature in light of the latest recommendations.European heart journal. Imaging methods and practice · 2025Review
- AI-based identification of patients who benefit from revascularization: a multicenter study.medRxiv : the preprint server for health sciences · 2025Article
- The Relationship Between Quantitative Ischemia, Early Revascularization, and Major Adverse Cardiovascular Events: A Multicenter Study.JACC. Advances · 2025Article
- Reassessing the Role of Ischemia Imaging: Insights from the ISCHEMIA Trial.Nuclear medicine and molecular imaging · 2024Review
- Value of Ischemia and Coronary Anatomy in Prognosis and Guiding Revascularization Among Patients With Stable Ischemic Heart Disease.Circulation. Cardiovascular imaging · 2024Article
- In 2023 PET myocardial perfusion imaging is preferred to invasive coronary angiography for the initial work-up of a symptomatic patient with a high coronary artery calcium score.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Detection and quantification of myocardial scar and LVEF with high efficiency digital SPECT: The expanding value proposition for clinical cardiology.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Chest Pain Evaluation: Diagnostic Testing.CJC open · 2023Review
- Interaction of impaired myocardial flow reserve and extent of myocardial ischemia assessed usingJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Coronary computed tomography angiography imaging features combined with computed tomography-fractional flow reserve, pericoronary fat attenuation index, and radiomics for the prediction of myocardial ischemia.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Decline in typical angina among patients referred for cardiac stress testing.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Optimizing patient centered care in the cardiac intensive care unit: Harness the safety, effectiveness, and incremental value of radionuclide perfusion, function, and molecular imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Imaging phenotypes and outcomes after revascularization in chronic coronary artery disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Utility of nuclear cardiovascular imaging in the cardiac intensive care unit.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Review
- Developing a framework for evaluating and comparing risk models.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Coronary computed tomography angiography and single-photon emission computerized tomography in chronic total occlusions: the Rosetta Stone for PCI planning?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Direct Risk Assessment From Myocardial Perfusion Imaging Using Explainable Deep Learning.JACC. Cardiovascular imaging · 2023Article
- Editorial: Debates in coronary artery disease: 2022.Frontiers in cardiovascular medicine · 2023Article
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Funding
Abstract
backgroundPrior studies with single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) have shown a survival benefit with early revascularization in patients with >10% to 12.5% ischemic myocardium. The relationship among positron emission tomography (PET)-derived extent of ischemia, early revascularization, and survival is unknown.
objectivesThe purpose of this study was to evaluate the association among percent ischemia on PET MPI, revascularization, and survival.
methodsA total of 16,029 unique consecutive patients who were undergoing Rubidium-82 rest-stress PET MPI from 2010 to 2016 were included. Patients with known cardiomyopathy and nondiagnostic perfusion results were excluded. Percent ischemic myocardium was estimated from a 17-segment model. Propensity scoring was used to account for nonrandomized referral to early revascularization (90 days of PET). A Cox model was developed, adjusting for propensity scores for early revascularization and percent ischemia, and an interaction between ischemia and early revascularization was tested.
resultsMedian follow-up was 3.7 years. Overall, 1,277 (8%) patients underwent early revascularization and 2,493 (15.6%) died (738 cardiac). Nearly 37% of patients (n = 5,902) had ischemia, with 13.5% (n = 2,160) having ≥10%. In propensity-adjusted analyses, there was a significant interaction between ischemia and early revascularization (p < 0.001 for all-cause and cardiac death), such that patients with greater ischemia had improved survival with early revascularization, with a potential ischemia threshold at 5% (upper limit 95% confidence interval at 10%). There was no differential association between ischemia and early revascularization on death based on history of known coronary artery disease (interaction p = 0.72).
conclusionsIn a contemporary cohort of patients undergoing PET MPI, patients with greater ischemia had a survival benefit from early revascularization. On exploratory analyses, this threshold was lower than that previously reported for SPECT. These findings require future validation in prospective cohorts or trials.
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