BACKGROUND: As an initial management strategy for stable ischemic heart disease (IHD), coronary revascularization therapy is thought to be equal to optimal medical therapy alone regarding prognosis. METHODS: Whether or not the effects of revascularization on the prognosis of patients with stable IHD are associated with the amount of ischemic myocardium detected by nuclear stress imaging was evaluated. This retrospective study analyzed data from 4629 patients with suspected or known IHD who underwent gated stress myocardial-perfusion SPECT at 117 hospitals in Japan. The follow-up periods were three years and the combined endpoints consisted of cardiac death, nonfatal myocardial infarction, and congestive heart failure requiring hospitalization. After matching propensity scores between patients who underwent early revascularization and those who did not (n=316 per group), we compared cardiac event rates in relation to the amount of ischemic myocardium. RESULTS: Cardiac event rates did not significantly differ between patients who underwent early revascularization and those who did not (5.4% vs. 6.4%). Among patients with ≤ 5%, 6-10%, and >10% ischemic myocardium, cardiac event rates were 8%, 3% and 0% respectively, who underwent early revascularization compared with 4.5%, 6.1%, and 12.3%, respectively, among those who did not. Cardiac event rates were significantly lower among patients with >10% ischemic myocardium who underwent early revascularization compared with those who did not (0% vs. 12.3%, p=0.0062). CONCLUSIONS: Coronary revascularization for stable IHD does not decrease major cardiac events in all patients but might do in patients with moderate to severe ischemia.
BACKGROUND: As an initial management strategy for stable ischemic heart disease (IHD), coronary revascularization therapy is thought to be equal to optimal medical therapy alone regarding prognosis. METHODS: Whether or not the effects of revascularization on the prognosis of patients with stable IHD are associated with the amount of ischemic myocardium detected by nuclear stress imaging was evaluated. This retrospective study analyzed data from 4629 patients with suspected or known IHD who underwent gated stress myocardial-perfusion SPECT at 117 hospitals in Japan. The follow-up periods were three years and the combined endpoints consisted of cardiac death, nonfatal myocardial infarction, and congestive heart failure requiring hospitalization. After matching propensity scores between patients who underwent early revascularization and those who did not (n=316 per group), we compared cardiac event rates in relation to the amount of ischemic myocardium. RESULTS: Cardiac event rates did not significantly differ between patients who underwent early revascularization and those who did not (5.4% vs. 6.4%). Among patients with ≤ 5%, 6-10%, and >10% ischemic myocardium, cardiac event rates were 8%, 3% and 0% respectively, who underwent early revascularization compared with 4.5%, 6.1%, and 12.3%, respectively, among those who did not. Cardiac event rates were significantly lower among patients with >10% ischemic myocardium who underwent early revascularization compared with those who did not (0% vs. 12.3%, p=0.0062). CONCLUSIONS: Coronary revascularization for stable IHD does not decrease major cardiac events in all patients but might do in patients with moderate to severe ischemia.
Authors: Joe X Xie; David E Winchester; Lawrence M Phillips; Rory Hachamovitch; Daniel S Berman; Ron Blankstein; Marcelo F Di Carli; Todd D Miller; Mouaz H Al-Mallah; Leslee J Shaw Journal: J Nucl Cardiol Date: 2017-07-27 Impact factor: 5.952
Authors: Bernhard Bischoff; Fabian Bamberg; Roy Marcus; Florian Schwarz; Hans-Christoph Becker; Alexander Becker; Maximilian Reiser; Konstantin Nikolaou Journal: Int J Cardiovasc Imaging Date: 2012-06-20 Impact factor: 2.357
Authors: Lawrence M Phillips; Rory Hachamovitch; Daniel S Berman; Ami E Iskandrian; James K Min; Michael H Picard; Raymond Y Kwong; Matthias G Friedrich; Marielle Scherrer-Crosbie; Sean W Hayes; Tali Sharir; Gilbert Gosselin; Marco Mazzanti; Roxy Senior; Rob Beanlands; Paola Smanio; Abhi Goyal; Mouaz Al-Mallah; Harmony Reynolds; Gregg W Stone; David J Maron; Leslee J Shaw Journal: J Nucl Cardiol Date: 2013-12 Impact factor: 5.952
Authors: Luiz Eduardo Mastrocola; Barbara Juarez Amorim; João Vicente Vitola; Simone Cristina Soares Brandão; Gabriel Blacher Grossman; Ronaldo de Souza Leão Lima; Rafael Willain Lopes; William Azem Chalela; Lara Cristiane Terra Ferreira Carreira; José Roberto Nolasco de Araújo; Cláudio Tinoco Mesquita; José Claudio Meneghetti Journal: Arq Bras Cardiol Date: 2020-02 Impact factor: 2.000