Open AccessDemonstration of ischemia in myocardial perfusion scintigraphy before coronary revascularization decreases acute coronary syndrome-related hospitalizations
Author(s) -
Hakan Kaya,
Ozan Kandemir,
Osman Beton,
Tarık Kıvrak,
Recep Kurt,
Mehmet Yılmaz
Publication year - 2017
Publication title -
world journal of nuclear medicine
Language(s) - English
Resource type - Journals
eISSN - 1607-3312
pISSN - 1450-1147
DOI - 10.4103/1450-1147.207279
Subject(s) - medicine , cardiology , revascularization , acute coronary syndrome , ischemia , diabetes mellitus , stent , perfusion , angina , unstable angina , coronary artery disease , myocardial infarction , endocrinology
In this study, we compared the patients who underwent coronary angiography (CAG), followed by revascularization by coronary artery stent implantation according to the CAG results without any evidence of ischemia with myocardial perfusion scintigraphy (MPS), and the patients who underwent revascularization by coronary artery stent implantation following the detection of ischemia in MPS before CAG in terms of the mortality and hospitalization due to acute coronary syndrome (ACS). Between January 2009 and January 2016, a total of 407 patients (52% males, 48% females; mean age: 66 ± 9 years; range: 40-85 years) who underwent CAG following diagnosis of stable angina and underwent coronary artery stenting were retrospectively analyzed. The patients were divided into two groups: Group 1 ( n = 200) included those who had MPS before CAG and in whom ischemia was detected and stent was implanted, and Group 2 ( n = 207) included those who had stent implantation according to the CAG results without prior MPS. The mean follow-up was 40 ± 18 months. Although there was no significant difference in the mortality rates between the groups, the rate of hospitalization due to ACS was significantly lower in Group 1 ( P = 0.112 vs. P = 0.022, respectively). According to the multivariate Cox-regression analysis, demonstration of ischemia in MPS before revascularization, statin use, clopidogrel use, and higher high-density lipoprotein cholesterol levels were found to be associated with a reduced risk of ACS-related hospitalization, whereas the presence of diabetes mellitus and smoking was found to be associated with an increased risk of ACS-related hospitalization.