ArticleEuropean journal of nuclear medicine and molecular imaging2026
Risk stratification with pre-operative myocardial perfusion imaging.
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- CT Attenuation Map-Derived Body Composition Is Associated with Cardiorespiratory Fitness in Multicenter External Validation.medRxiv : the preprint server for health sciences · 2026Article
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19 authors.
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Abstract
purposeMyocardial perfusion imaging (MPI) is frequently used to improve cardiac risk prediction in patients undergoing non-cardiac surgery. However, the data supporting this practice is derived from single center studies and predates current therapy for coronary artery disease (CAD). We evaluated the association between pre-operative testing indication and outcomes as well as predictors of death or myocardial infarction (MI) in these patients.
methodsWe include patients from the international, multicenter REFINE-SPECT registry (13 sites). Based on referral indication, patients were classified as pre-operative testing indications and non-pre-operative testing. We evaluated the associations between pre-operative testing and incidence of death or MI. We then evaluated associations with death or MI in patients referred for pre-operative testing compared to other patients.
resultsIn total, 32,711 patients were included with pre-operative testing as the indication in 2,173(6.6%) patients. Patients referred for pre-operative testing were more likely to experience death or MI (annualized rate 4.4% vs 1.6%, p < 0.001). In patients referred for pre-operative testing, stress, rest, and ischemic total perfusion deficit were associated with death or MI. Rest total perfusion deficit (adjusted hazard ratio [HR] 1.25, 95% confidence interval [CI] 1.07 - 1.45) was independently associated with death or MI, but pharmacologic stress testing was not (adjusted HR 0.88, 95% CI 0.70 - 1.12).
conclusionPatients undergoing pre-operative SPECT MPI are at increased cardiovascular risk which may reflect selection bias or unmeasured confounders. Resting perfusion abnormalities may identify patients at higher risk, potentially helping guide peri-operative care.
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