Background. Randomized trials have challenged the role of revascularization in stable coronary artery disease. We aimed to appraise the impact of revascularization on ischemia in patients undergoing serial myocardial perfusion scintigraphy (MPS).Methods. We queried our institutional database for stable subjects undergoing serial MPS and appraised the impact of revascularization on changes in ischemia.Results. A total of 3631 patients were included: 967 (27%) undergoing revascularization and 2664 (73%) receiving medical therapy only. Patients treated with revascularization had a significantly lower burden of myocardial ischemia at follow-up (odds ratio = 0.577 [95% confidence interval 0.483-0.689] vs medical therapy, P < .001). Among all those having moderate or severe ischemia at baseline, revascularization was associated with a follow-up prevalence of 80% for no, minimal, or mild ischemia and 20% for moderate or severe ischemia, vs 43% and 57% for medical therapy (P < .001). Even at multivariable analysis and propensity-adjusted, and propensity-matched analyses, revascularization was associated with a significantly lower prevalence of moderate or severe ischemia at follow-up (respectively P < .001, P = .001, and P = .042).Conclusions. Revascularization appears superior to medical therapy in reducing ischemic burden and normalizing myocardial perfusion among subjects with moderate or severe ischemia at baseline.

Nudi, F., Di Belardino, N., Versaci, F., Pinto, A., Procaccini, E., Neri, G., et al. (2017). Impact of coronary revascularization vs medical therapy on ischemia among stable patients with or suspected coronary artery disease undergoing serial myocardial perfusion scintigraphy. JOURNAL OF NUCLEAR CARDIOLOGY, 24(5), 1690-1698 [10.1007/s12350-016-0504-5].

Impact of coronary revascularization vs medical therapy on ischemia among stable patients with or suspected coronary artery disease undergoing serial myocardial perfusion scintigraphy

Nudi F.;Versaci F.;Peruzzi M.;Schillaci O.;Gaspardone A.;Tomai F.;
2017-01-01

Abstract

Background. Randomized trials have challenged the role of revascularization in stable coronary artery disease. We aimed to appraise the impact of revascularization on ischemia in patients undergoing serial myocardial perfusion scintigraphy (MPS).Methods. We queried our institutional database for stable subjects undergoing serial MPS and appraised the impact of revascularization on changes in ischemia.Results. A total of 3631 patients were included: 967 (27%) undergoing revascularization and 2664 (73%) receiving medical therapy only. Patients treated with revascularization had a significantly lower burden of myocardial ischemia at follow-up (odds ratio = 0.577 [95% confidence interval 0.483-0.689] vs medical therapy, P < .001). Among all those having moderate or severe ischemia at baseline, revascularization was associated with a follow-up prevalence of 80% for no, minimal, or mild ischemia and 20% for moderate or severe ischemia, vs 43% and 57% for medical therapy (P < .001). Even at multivariable analysis and propensity-adjusted, and propensity-matched analyses, revascularization was associated with a significantly lower prevalence of moderate or severe ischemia at follow-up (respectively P < .001, P = .001, and P = .042).Conclusions. Revascularization appears superior to medical therapy in reducing ischemic burden and normalizing myocardial perfusion among subjects with moderate or severe ischemia at baseline.
2017
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE
English
Con Impact Factor ISI
Cardiovascular disease; coronary artery bypass grafting; coronary artery disease; maximal ischemia score; myocardial ischemia; myocardial perfusion imaging; myocardial perfusion scintigraphy; Aged; Coronary Artery Disease; Exercise Test; Female; Humans; Male; Middle Aged; Multivariate Analysis; Myocardial Ischemia; Odds Ratio; Prevalence; Retrospective Studies; Tomography, Emission-Computed, Single-Photon; Myocardial Perfusion Imaging; Myocardial Revascularization; Radionuclide Imaging
https://link.springer.com/article/10.1007%2Fs12350-016-0504-5
Nudi, F., Di Belardino, N., Versaci, F., Pinto, A., Procaccini, E., Neri, G., et al. (2017). Impact of coronary revascularization vs medical therapy on ischemia among stable patients with or suspected coronary artery disease undergoing serial myocardial perfusion scintigraphy. JOURNAL OF NUCLEAR CARDIOLOGY, 24(5), 1690-1698 [10.1007/s12350-016-0504-5].
Nudi, F; Di Belardino, N; Versaci, F; Pinto, A; Procaccini, E; Neri, G; Vetere, M; Frati, G; Peruzzi, M; Schillaci, O; Gaspardone, A; Tomai, F; Biondi...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/212697
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