The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.
Impact of ischaemia and scar on the therapeutic benefit derived from myocardial revascularization vs. medical therapy among patients undergoing stress-rest myocardial perfusion scintigraphy
Abstract
AIMS: Although pre-revascularization ischaemia testing is recommended, the interaction between the extent of ischaemia and myocardial scar with performance of revascularization on patient survival is unclear. METHODS AND RESULTS: We identified 13 969 patients who underwent adenosine or exercise stress SPECT myocardial perfusion scintigraphy (MPS). The percent myocardium ischaemic (%I) and fixed (%F) were calculated using 5 point/20-segment MPS scoring. Patients lost to follow-up (2.8%) were excluded leaving 13 555 patients [35% with history (Hx) of known coronary artery disease (CAD), 65% exercise stress, 61% male, age 66 ± 12]. Follow-up was performed at 12-18 months for early revascularization and at >7 years for all-cause death (ACD) (mean follow-up 8.7 ± 3.3 years). All-cause death was modelled using Cox proportional hazards modelling adjusting for logistic-based propensity scores, MPS, revascularization, and baseline characteristics. During FU, 3893 ACD (29%, 3.3%/year) and 1226 early revascularizations (9.0%) occurred. After risk-adjustment, a three-way interaction was present between %I, early revascularization, and HxCAD, such that %I identified a survival benefit with early revascularization in patients without prior myocardial infarction (MI), whereas no such benefit was present in patients with prior MI (overall model χ(2)= 3932, P < 0.001; interaction P < 0.021). Further modelling revealed that after excluding patients with scar >10% total myocardium, %I identified a survival benefit in all patients. CONCLUSION: In this large observational series with long-term follow-up, patients with significant ischaemia and without extensive scar were likely to realize a survival benefit from early revascularization. In contrast, the survival of patients with minimal ischaemia was superior with medical therapy without early revascularization.
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Optimal Medical Therapy with or without PCI for Stable Coronary Disease
Boden, W. E., O'Rourke, R. A., Teo, K. K., Hartigan, P. M., Maron, D. J., Kostuk, W. J., Knudtson, M., Dada, M., Casperson, P., Harris, C. L., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa070829 · Cited by 4,699
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2018 ESC/EACTS guidelines on myocardial revascularization
Neumann, F.-J., Sousa-Uva, M., Ahlsson, A., Alfonso, F., Banning, A. P., Benedetto, U., Byrne, R. A., Collet, J.-P., Falk, V., Head, S. J., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehy394 · Cited by 7,167
2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes
Knuuti, J., Wijns, W., Saraste, A., Capodanno, D., Barbato, E., Funck-Brentano, C., Prescott, E., Storey, R. F., Deaton, C., Cuisset, T., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz425 · Cited by 7,166
2013 ESC guidelines on the management of stable coronary artery disease
Task Force Members, Montalescot, G., Sechtem, U., Achenbach, S., Andreotti, F., Arden, C., Budaj, A., Bugiardini, R., Crea, F., Cuisset, T., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht296 · Cited by 4,510
2024 ESC Guidelines for the management of chronic coronary syndromes
Vrints, C., Andreotti, F., Koskinas, K. C., Rossello, X., Adamo, M., Ainslie, J., Banning, A. P., Budaj, A., Buechel, R. R., Chiariello, G. A., et al. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae177 · Cited by 2,774
2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease
Pelliccia, A., Sharma, S., Gati, S., Bäck, M., Börjesson, M., Caselli, S., Collet, J.-P., Corrado, D., Drezner, J. A., Halle, M., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehaa605 · Cited by 1,958
Metadata
- Authors
- Hachamovitch, R., Rozanski, A., Shaw, L. J., Stone, G. W., Thomson, L. E. J., Friedman, J. D., Hayes, S. W., Cohen, I., Germano, G., & Berman, D. S.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-01-21
- Volume
- 32
- Issue
- 8
- Pages
- 1012-1024
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2149888635
- Cited by
- 481
- References
- 1
- FWCI
- 25.28
- Type
- journal article
- Language
- en
- Open access
- closed
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- Hachamovitch, R., Rozanski, A., Shaw, L. J., Stone, G. W., Thomson, L. E. J., Friedman, J. D., Hayes, S. W., Cohen, I., Germano, G., & Berman, D. S. (2011). Impact of ischaemia and scar on the therapeutic benefit derived from myocardial revascularization vs. medical therapy among patients undergoing stress-rest myocardial perfusion scintigraphy. European Heart Journal. https://doi.org/10.1093/eurheartj/ehq500
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
