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Short- and long-term prognostic performance of exercise ECG and myocardial perfusion SPECT.
Kraen, M; Akil, S; Hedén, B; Kjellström, B; Berg, J; Ostenfeld, E; Arheden, H; Carlsson, M; Engblom, H.
Afiliación
  • Kraen M; Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
  • Akil S; Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
  • Hedén B; Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
  • Kjellström B; Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
  • Berg J; Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
  • Ostenfeld E; Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
  • Arheden H; Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
  • Carlsson M; Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
  • Engblom H; Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden.
Clin Physiol Funct Imaging ; 2024 Aug 18.
Article en En | MEDLINE | ID: mdl-39154282
ABSTRACT

BACKGROUND:

Myocardial perfusion SPECT (MPS) and exercise electrocardiography (Ex-ECG) results are of prognostic importance for short-term follow up duration. However, the value of MPS or Ex-ECG findings for long-term risk assessment is less evident as underlying risk factors for ischemic heart disease (IHD) gain in importance.

OBJECTIVES:

To assess the short- and long-term prognostic value of MPS and Ex-ECG in relation to known risk factors. METHODS AND MATERIALS An observational study of 908 patients (age 63 years, 49% male, 45% prior IHD) referred for MPS and Ex-ECG. Follow-up was divided into two periods (short-term <5 years and long-term >5 years). Cardiac events were defined as a composite of acute myocardial infarction, unstable angina, unplanned revascularization and cardiovascular death.

RESULTS:

The composite endpoint occurred in 95 patients (short-term follow up) and in 94 patients (long-term follow up). In multivariable models stress testing had a strong predictive value for short-term follow up (HR for MPS = 2.9, CI = 1.9-4.5, p < 0.001 and HR for Ex-ECG = 2.1, CI 1.3-3.3, p = 0.002), but no predictive value for long-term follow up (HR for MPS = 0.9, CI = 0.5-1.5, p = 0.70 and HR for Ex-ECG = 1.0, CI = 0.6-1.6, p = 0.92). Male sex and prior IHD were significant predictors regardless of follow up duration. Age, diabetes and decreased exercise capacity were risk factors for long-term follow up.

CONCLUSIONS:

The prognostic value of MPS and Ex-ECG results are strong for short-term follow up but diminish over time and do not contribute significantly in multivariable models after 5 years. Long-term prognosis is primarily governed by underlying risk factors and exercise capacity.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Physiol Funct Imaging Asunto de la revista: FISIOLOGIA / PATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Physiol Funct Imaging Asunto de la revista: FISIOLOGIA / PATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido