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Prognostic utility of ischemic response in functional imaging tests (SPECT or stress echocardiography) in low-risk unstable angina patients
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Abstract
Background: The aim of this study is to determine the ability of ischemic response in imaging stress tests (single-photon emission computed tomography [SPECT] or stress echocardiography [SE]) to predict events in low-risk unstable angina patients.
Methods: Three hundred and fifty-nine patients with unstable angina (< 24 h), asymptomatic at admission, without ST-segment elevation or depression, normal troponins, and undergoing SPECT (n = 188) or SE (n = 171) during hospitalization (median = 1 day) were included. A positive imaging test (IMAGING+) was defined as the presence of reversible perfusion defects or wall motion abnormalities in at least 2 contiguous segments. Multivariate models were constructed using these results and clinical variables to predict events at 6 months.
Results: Ninety-nine (27%) patients had IMAGING+, 72/188 (38%) in SPECT and 27/17 (16%) in SE (p < 0.0001). Events occurred in 84 (23%) patients: 4 had myocardial infarction, 47 new hospitalizations due to angina and 33 coronary artery revascularizations. Inde-pendent predictors of coronary artery disease were: IMAGING+ (OR: 6.4, 95% CI: 3.4–11.8, p < 0.0001), history of coronary artery disease (OR: 2.5, 95% CI: 1.2–5.2, p < 0.02) and TIMI risk (OR: 1.5, 95% CI: 1.1–2.2, p < 0.03).
Conclusions: In low-risk unstable angina patients, an ischemic response in functional stress tests (SPECT or SE) was associated with adverse events and severe coronary artery disease.
Abstract
Background: The aim of this study is to determine the ability of ischemic response in imaging stress tests (single-photon emission computed tomography [SPECT] or stress echocardiography [SE]) to predict events in low-risk unstable angina patients.
Methods: Three hundred and fifty-nine patients with unstable angina (< 24 h), asymptomatic at admission, without ST-segment elevation or depression, normal troponins, and undergoing SPECT (n = 188) or SE (n = 171) during hospitalization (median = 1 day) were included. A positive imaging test (IMAGING+) was defined as the presence of reversible perfusion defects or wall motion abnormalities in at least 2 contiguous segments. Multivariate models were constructed using these results and clinical variables to predict events at 6 months.
Results: Ninety-nine (27%) patients had IMAGING+, 72/188 (38%) in SPECT and 27/17 (16%) in SE (p < 0.0001). Events occurred in 84 (23%) patients: 4 had myocardial infarction, 47 new hospitalizations due to angina and 33 coronary artery revascularizations. Inde-pendent predictors of coronary artery disease were: IMAGING+ (OR: 6.4, 95% CI: 3.4–11.8, p < 0.0001), history of coronary artery disease (OR: 2.5, 95% CI: 1.2–5.2, p < 0.02) and TIMI risk (OR: 1.5, 95% CI: 1.1–2.2, p < 0.03).
Conclusions: In low-risk unstable angina patients, an ischemic response in functional stress tests (SPECT or SE) was associated with adverse events and severe coronary artery disease.
Keywords
unstable angina, functional test, prognostic
About this articleTitle
Prognostic utility of ischemic response in functional imaging tests (SPECT or stress echocardiography) in low-risk unstable angina patients
Journal
Issue
Pages
160-164
Published online
2015-04-28
Page views
1534
Article views/downloads
1426
DOI
10.5603/CJ.a2014.0052
Pubmed
Bibliographic record
Cardiol J 2015;22(2):160-164.
Keywords
unstable angina
functional test
prognostic
Authors
Marcelo Trivi
Ricardo Ronderos
Alejandro Meretta
Diego Conde
Gustavo Avegliano
