Complete revascularization determined by myocardial perfusion imaging could improve the outcomes of patients with stable coronary artery disease, compared with incomplete revascularization and no revascularization
机构：[1]Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China[2]Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China[3]Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medizinische Universitat Wien, Wien, Austria[4]Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China医技科室核医学科首都医科大学附属安贞医院
ObjectivesTo compare the outcomes among patients treated by complete coronary revascularization (CCR) or incomplete coronary revascularization (ICR) and no coronary revascularization (NCR) by myocardial perfusion imaging (MPI), as well as to evaluate the impact of severity of ischemia on patients with coronary artery disease (CAD) by different therapy strategies.BackgroundUsing myocardial ischemia severity determined by MPI guiding treatment strategies for CAD patients still lacks strong clinical evidences.MethodsConsecutive patients (N=286) underwent clinical stress-rest SPECT MPI and were retrospectively followed-up. For assessment of outcome of treatment, all patients were classified into three groups (CCR, ICR, and NCR), and further divided into two subgroups as mild ischemia (<10% ischemic myocardium) and moderate-severe ischemia (10% ischemic myocardium). All-cause death was defined as the primary endpoint, and the composite of deaths, nonfatal myocardial infarction, and repeat revascularization (MACE) as the secondary endpoint.ResultsTwo-hundred eighty-six patients were followed-up for 4621months. Thirty deaths and 65 MACEs were recorded. Patients treated by revascularization had significantly lower MACE (P<.001) but not mortality (P=.158) than patients treated by NCR. Outcomes of CCR related to mortality rate were greater than ICR and NCR (death: P=.019, MACE: P<.001). In patients with moderate-severe ischemia, CCR showed improved outcomes than ICR and NCR (death: P=.034; and MACE: P<.001). In patients with mild ischemia, the outcomes of CCR, ICR, and NCR had no significant difference (P>.05). Multivariate regression Cox analysis revealed that summed difference score [death: HR 1.09 (1.03, 1.15), P=.004] was an independent risk factor and CCR was an independent negative predictor [death: HR 0.31 (0.12, 0.81), P=.017; MACE: HR 0.30 (0.16, 0.57), P<.001].Conclusionsp id=Par5Outcomes of patients treated by CCR were most likely more promising in comparison with treatment of ICR and NCR, especially when patients had over 10% ischemic myocardium.
基金：
Natural Science Foundation of ChinaNational Natural Science Foundation of China [81571717, 81071177]; Beijing Municipal Science and Technology Project [Z131107002213181]
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2018]版：
大类|2 区医学
小类|2 区核医学3 区心脏和心血管系统
最新[2023]版：
大类|4 区医学
小类|4 区心脏和心血管系统4 区核医学
JCR分区：
出版当年[2017]版：
Q1RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGINGQ2CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版：
Q2CARDIAC & CARDIOVASCULAR SYSTEMSQ2RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
第一作者机构：[1]Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
通讯作者：
通讯机构：[2]Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China[3]Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medizinische Universitat Wien, Wien, Austria[4]Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China[*1]Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medizinische Universitat Wien, Wien[*2]Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, People’s Republic of China
推荐引用方式(GB/T 7714)：
Li Jiehui,Yang Xiubin,Tian Yueqin,et al.Complete revascularization determined by myocardial perfusion imaging could improve the outcomes of patients with stable coronary artery disease, compared with incomplete revascularization and no revascularization[J].JOURNAL OF NUCLEAR CARDIOLOGY.2019,26(3):944-953.doi:10.1007/s12350-017-1145-z.
APA：
Li, Jiehui,Yang, Xiubin,Tian, Yueqin,Wei, Hongxing,Hacker, Marcus...&Zhang, Xiaoli.(2019).Complete revascularization determined by myocardial perfusion imaging could improve the outcomes of patients with stable coronary artery disease, compared with incomplete revascularization and no revascularization.JOURNAL OF NUCLEAR CARDIOLOGY,26,(3)
MLA：
Li, Jiehui,et al."Complete revascularization determined by myocardial perfusion imaging could improve the outcomes of patients with stable coronary artery disease, compared with incomplete revascularization and no revascularization".JOURNAL OF NUCLEAR CARDIOLOGY 26..3(2019):944-953
