The prognostic implications of ST-segment and T-wave abnormalities in patients undergoing regadenoson stress SPECT myoca
- PDF / 807,869 Bytes
- 12 Pages / 593.972 x 792 pts Page_size
- 40 Downloads / 138 Views
Department of Medicine, Cook County Health, Chicago, IL Division of Cardiology, Cook County Health, Chicago, IL Division of Cardiology, Rush University Medical Center, Chicago, IL
Received Jul 4, 2020; accepted Sep 11, 2020 doi:10.1007/s12350-020-02382-z
Background. The prognostic implications of ST-segment and T-wave (ST/T) abnormalities in patients undergoing stress SPECT-myocardial perfusion imaging (MPI) are not well defined. Methods and Results. This was a single-center, retrospective cohort study of consecutive patients who underwent regadenoson stress SPECT-MPI. Patients with baseline electrocardiogram (ECG) abnormalities that impede ST/T analysis or those with known coronary artery disease were excluded. Patients were categorized as having primary ST abnormalities, secondary ST/T abnormalities due to ventricular hypertrophy or right bundle branch block, Twave abnormalities, or normal ECG. The primary outcome was major adverse cardiovascular events (MACE) defined as the composite of cardiac death or myocardial infarction. Among 6,059 subjects, 1912 (32%) had baseline ST/T abnormalities. During a mean follow-up of 2.3 ± 1.9 years, the incidence of MACE was significantly higher among patients with secondary ST/T abnormalities compared to those with normal ECG (HR 2.05; 95% confidence interval [CI], 1.04-4.05; P = 0.039). No significant difference in MACE was observed among patients with primary ST abnormalities (HR 1.64; CI 0.87-3.06; P = 0.124) or T-wave abnormalities (HR 1.15; CI 0.62-2.16; P = 0.658) compared with patients who had normal ECG. Among patients with secondary ST/T changes, abnormal MPI was not associated with a significant increase in MACE rates compared to normal MPI (HR 1.18; CI 0.31-4.58; P = 0.808). However, abnormal MPI was associated with higher MACE rates among patients with primary ST abnormalities (HR 4.50; CI 1.44-14.10; P = 0.005) and T-wave abnormalities (HR 3.74; CI 1.2011.68; P = 0.015). Similarly, myocardial ischemia on regadenoson stress SPECT-MPI was not associated with a significant increase in MACE rates in patients with secondary ST/T Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02382-z) contains supplementary material, which is available to authorized users. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarises the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com. The authors have also provided an audio summary of the article, which is available to download as ESM, or to listen to via the JNC/ASNC Podcast. Funding The study was funded, in part, by Astellas Pharma Global Development (Northbrook, IL). The funding source had no input in the study design, execution, data analysis and interpretation, or manuscript preparation and approval.
Tweet Baseline ST/T abnormalities have significant prognostic implications. #Regadenoson #MPI provides additional risk stratification. @RamiDouk
Data Loading...
