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Additional value of the coronary artery calcium score in patients for whom myocardial perfusion imaging is challenging
M. Havel, P. Koranda, V. Kincl, L. Quinn, M. Kamínek,
Language English Country Poland
Document type Journal Article
NLK
Free Medical Journals
from 2003
Medline Complete (EBSCOhost)
from 2013-04-01
ROAD: Directory of Open Access Scholarly Resources
from 2003
PubMed
30835334
DOI
10.5603/kp.a2019.0037
Knihovny.cz E-resources
- MeSH
- Kidney Failure, Chronic complications MeSH
- Myocardial Ischemia complications diagnosis diagnostic imaging MeSH
- Tomography, Emission-Computed, Single-Photon MeSH
- Coronary Vessels diagnostic imaging MeSH
- Middle Aged MeSH
- Humans MeSH
- Multidetector Computed Tomography * MeSH
- Prognosis MeSH
- Proportional Hazards Models MeSH
- Aged MeSH
- Vascular Calcification complications diagnosis diagnostic imaging MeSH
- Myocardial Perfusion Imaging * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND Determination of prognosis based on ischemia detection, using single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), can be challenging in patients with multiple affected coronary arteries. AIMS The aim of the study was to examine the outcomes of SPECT-MPI combined with the coronary artery calcium score (CACS) to identify predictors of adverse cardiac events (ACEs) in patients for whom ischemia detection may be difficult using SPECT-MPI. METHODS The study group included 195 patients with a history of chronic kidney disease, suspected ischemic cardiomyopathy, or left bundle branch block. All patients underwent SPECT-MPI and CACS evaluation. During the follow-up, ACEs were recorded. Perfusion and functional parameters as well as the CACS were analyzed to find the predictors of ACEs. RESULTS The ACEs were recorded in 58 individuals (29.7%) and were significantly associated with ischemia (P <0.001), abnormal functional parameters (P = 0.04), and higher CACSs (P <0.001). The optimal cutoff value of the CACS to predict an ACE was 530. Cox proportional hazards models revealed that age, mild and severe ischemia, functional abnormalities, and a CACS of 530 or higher were significant predictors of ACEs. In the subgroup of individuals without ischemia, a CACS of 530 or higher was significantly associated with poor outcome, while we recorded only 3 ACEs in these patients when the CACS was lower than 530. CONCLUSIONS The addition of the CACS to SPECT-MPI improves the identification of patients at higher risk for ACEs, even in individuals for whom SPECT-MPI is challenging.
Department of Nuclear Medicine University Hospital Ostrava Ostrava Czech Republic
International Clinical Research Center Center of Molecular Imaging Brno Czech Republic
References provided by Crossref.org
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- $a BACKGROUND Determination of prognosis based on ischemia detection, using single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), can be challenging in patients with multiple affected coronary arteries. AIMS The aim of the study was to examine the outcomes of SPECT-MPI combined with the coronary artery calcium score (CACS) to identify predictors of adverse cardiac events (ACEs) in patients for whom ischemia detection may be difficult using SPECT-MPI. METHODS The study group included 195 patients with a history of chronic kidney disease, suspected ischemic cardiomyopathy, or left bundle branch block. All patients underwent SPECT-MPI and CACS evaluation. During the follow-up, ACEs were recorded. Perfusion and functional parameters as well as the CACS were analyzed to find the predictors of ACEs. RESULTS The ACEs were recorded in 58 individuals (29.7%) and were significantly associated with ischemia (P <0.001), abnormal functional parameters (P = 0.04), and higher CACSs (P <0.001). The optimal cutoff value of the CACS to predict an ACE was 530. Cox proportional hazards models revealed that age, mild and severe ischemia, functional abnormalities, and a CACS of 530 or higher were significant predictors of ACEs. In the subgroup of individuals without ischemia, a CACS of 530 or higher was significantly associated with poor outcome, while we recorded only 3 ACEs in these patients when the CACS was lower than 530. CONCLUSIONS The addition of the CACS to SPECT-MPI improves the identification of patients at higher risk for ACEs, even in individuals for whom SPECT-MPI is challenging.
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