Prognostic value of coronary computed tomography angiography compared to radionuclide myocardial perfusion imaging in patients With coronary stents
ObjectivesThe aim of this study is to compare the prognostic value of coronary computed tomography angiography (CCTA) with single-photon emission computed tomography (SPECT) in predicting cardiovascular events in patients with stents.DesignRetrospective analysis.SettingUniversity Hospital, London, O...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1087113/full |
| _version_ | 1797868147191054336 |
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| author | Rami M. Abazid Jonathan G. Romsa James C. Warrington Cigdem Akincioglu Osama A. Smettei Yves Bureau Yves Bureau Nikolaos Tzemos William C. Vezina |
| author_facet | Rami M. Abazid Jonathan G. Romsa James C. Warrington Cigdem Akincioglu Osama A. Smettei Yves Bureau Yves Bureau Nikolaos Tzemos William C. Vezina |
| author_sort | Rami M. Abazid |
| collection | DOAJ |
| description | ObjectivesThe aim of this study is to compare the prognostic value of coronary computed tomography angiography (CCTA) with single-photon emission computed tomography (SPECT) in predicting cardiovascular events in patients with stents.DesignRetrospective analysis.SettingUniversity Hospital, London, Ontario Canada.ParticipantsBetween January 2007 and December 2018, 119 patients post-percutaneous coronary intervention (PCI) who were referred for hybrid imaging with CTA and 2-day rest/stress SPECT were enrolled.Primary and secondary outcome measuresPatients were followed for any major adverse cardiovascular event (MACE) including: All-cause mortality, Non-fatal myocardial infarction (MI), Unplanned revascularization, Cerebrovascular accident and hospitalization for arrhythmia or heart failure. We define hard cardiac events (HCE) as: cardiac death, non-fatal MI or unplanned revascularization. We used two cut-off values to define obstructive lesions with CCTA ≥50% and ≥70% in any coronary segment. SPECT scan defined as abnormal in the presence of >5% reversible myocardial perfusion defect.ResultsDuring the follow-up period of 7.2 ± 3.4 years. 45/119 (37.8%) patients experienced 57 MACE: Ten deaths (2 cardiac deaths and 8 of non-cardiac deaths), 29 acute coronary syndrome including non-fatal MI (25 required revascularization), 7 hospitalizations for heart failure, 6 cerebrovascular accidents and 5 new atrial fibrillation. 31 HCEs were reported. Cox regression analysis showed that obstructive coronary stenosis (≥50% and ≥70%) and abnormal SPECT were associated of MACE (p = 0.037, 0.018 and 0.026), respectively. In contrast, HCEs were significantly associated with obstructive coronary stenosis of ≥50% and ≥70% with p = 0.004 and p = 0.007, respectively. In contrast, abnormal SPECT was a nonsignificant predictor of HCEs (p = 0.062).ConclusionObstructive coronary artery stenosis on CCTA can predict MACE and HCE. However, abnormal SPECT can only predict MACE but not HCE in patients post-PCI with a follow-up period of approximately 7 years. |
| first_indexed | 2024-04-09T23:52:33Z |
| format | Article |
| id | doaj.art-7aa1c6b40aa64d0ab711ab703c7db419 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-09T23:52:33Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-7aa1c6b40aa64d0ab711ab703c7db4192023-03-17T05:46:03ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-03-011010.3389/fcvm.2023.10871131087113Prognostic value of coronary computed tomography angiography compared to radionuclide myocardial perfusion imaging in patients With coronary stentsRami M. Abazid0Jonathan G. Romsa1James C. Warrington2Cigdem Akincioglu3Osama A. Smettei4Yves Bureau5Yves Bureau6Nikolaos Tzemos7William C. Vezina8Division of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, ON, CanadaDivision of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, ON, CanadaDivision of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, ON, CanadaDivision of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, ON, CanadaDivision of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, ON, CanadaMedical Biophysics, Western University, London, ON, CanadaDepartment of Psycholoy, Lawson Health Research Institute, London, ON, CanadaDivision of Cardiology, Department of Internal Medicine, London Health Sciences Centre, University Hospital, London, ON, CanadaDivision of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, ON, CanadaObjectivesThe aim of this study is to compare the prognostic value of coronary computed tomography angiography (CCTA) with single-photon emission computed tomography (SPECT) in predicting cardiovascular events in patients with stents.DesignRetrospective analysis.SettingUniversity Hospital, London, Ontario Canada.ParticipantsBetween January 2007 and December 2018, 119 patients post-percutaneous coronary intervention (PCI) who were referred for hybrid imaging with CTA and 2-day rest/stress SPECT were enrolled.Primary and secondary outcome measuresPatients were followed for any major adverse cardiovascular event (MACE) including: All-cause mortality, Non-fatal myocardial infarction (MI), Unplanned revascularization, Cerebrovascular accident and hospitalization for arrhythmia or heart failure. We define hard cardiac events (HCE) as: cardiac death, non-fatal MI or unplanned revascularization. We used two cut-off values to define obstructive lesions with CCTA ≥50% and ≥70% in any coronary segment. SPECT scan defined as abnormal in the presence of >5% reversible myocardial perfusion defect.ResultsDuring the follow-up period of 7.2 ± 3.4 years. 45/119 (37.8%) patients experienced 57 MACE: Ten deaths (2 cardiac deaths and 8 of non-cardiac deaths), 29 acute coronary syndrome including non-fatal MI (25 required revascularization), 7 hospitalizations for heart failure, 6 cerebrovascular accidents and 5 new atrial fibrillation. 31 HCEs were reported. Cox regression analysis showed that obstructive coronary stenosis (≥50% and ≥70%) and abnormal SPECT were associated of MACE (p = 0.037, 0.018 and 0.026), respectively. In contrast, HCEs were significantly associated with obstructive coronary stenosis of ≥50% and ≥70% with p = 0.004 and p = 0.007, respectively. In contrast, abnormal SPECT was a nonsignificant predictor of HCEs (p = 0.062).ConclusionObstructive coronary artery stenosis on CCTA can predict MACE and HCE. However, abnormal SPECT can only predict MACE but not HCE in patients post-PCI with a follow-up period of approximately 7 years.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1087113/fullstentpercutaneous coronary interventionprognostic valuecomputed tomography angiographysingle-photon emission computed tomography |
| spellingShingle | Rami M. Abazid Jonathan G. Romsa James C. Warrington Cigdem Akincioglu Osama A. Smettei Yves Bureau Yves Bureau Nikolaos Tzemos William C. Vezina Prognostic value of coronary computed tomography angiography compared to radionuclide myocardial perfusion imaging in patients With coronary stents Frontiers in Cardiovascular Medicine stent percutaneous coronary intervention prognostic value computed tomography angiography single-photon emission computed tomography |
| title | Prognostic value of coronary computed tomography angiography compared to radionuclide myocardial perfusion imaging in patients With coronary stents |
| title_full | Prognostic value of coronary computed tomography angiography compared to radionuclide myocardial perfusion imaging in patients With coronary stents |
| title_fullStr | Prognostic value of coronary computed tomography angiography compared to radionuclide myocardial perfusion imaging in patients With coronary stents |
| title_full_unstemmed | Prognostic value of coronary computed tomography angiography compared to radionuclide myocardial perfusion imaging in patients With coronary stents |
| title_short | Prognostic value of coronary computed tomography angiography compared to radionuclide myocardial perfusion imaging in patients With coronary stents |
| title_sort | prognostic value of coronary computed tomography angiography compared to radionuclide myocardial perfusion imaging in patients with coronary stents |
| topic | stent percutaneous coronary intervention prognostic value computed tomography angiography single-photon emission computed tomography |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1087113/full |
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