Different degrees of summed difference perfusion score in women: influence on the prognostic variables associated with cardiac events.

IF 1.3 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Nuclear Medicine Communications Pub Date : 2024-10-31 DOI:10.1097/MNM.0000000000001921

Guillermo Romero-Farina, Santiago Aguadé-Bruix, Ignacio Ferreira-González

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Abstract

Objective: Evaluating the predictive models (PM) for a major adverse cardiac event (MACE) only in women with abnormal summed difference score (SDS ≥ 1), borderline myocardial ischemia (borderline-MIsch: SDS = 1), MIsch (SDS ≥ 2), mild-MIsch (SDS = 2-4), and moderate-severe MIsch (ms-MIsch: SDS ≥ 5).

Methods: Between January 2000 and January 2018, of 25 943 consecutive patients who underwent gated single-photon emission computed tomography myocardial perfusion imaging (gSPECT-MPI) for coronary risk stratification; 717 women (age 68.37 ± 3.4 years) with an abnormal SDS ≥ 1 were included. During the follow-up (mean 4 ± 2.9 years) post-gSPECT-MPI, MACE (unstable angina, nonfatal myocardial infarction, coronary revascularization, cardiac death) was assessed.

Results: In the global women cohort with abnormal SDS (n = 717), the PM was angina [hazard ratio (HR): 1.65, P = 0.016], diabetes (HR: 1.72, P = 0.004), beta-blockers (HR: 1.61, P = 0.009), pharmacological stress (HR: 1.74, P = 0.007), ↓ segment (ST) mm ≥ 1 (HR: 1.54, P = 0.039), and moderate-to-severe abnormal summed stress score (ms-SSS) (HR: 2.92, P = 0.001). In borderline-MIsch group (n = 208), the PM was previous myocardial infarction (HR: 3.8, P = 0.001), nitrates (HR: 2.13, P = 0.047), pharmacological stress (HR: 4.81, P < 0.001), and ↓ST mm ≥ 1 (HR: 3.07, P = 0.014). In MIsch group (n = 509), the PM model was ms-SSS (HR: 2.25, P = 0.001), diabetes (HR: 1.73, P = 0.011), angina (HR: 1.68, P = 0.029), beta-blockers (HR: 1.59, P = 0.026), and ms-MIsch (HR: 1.62, P = 0.044). In mild-MIsch group (n = 399), the PM was ms-SSS (HR: 2.55, P = 0.003), diabetes (HR: 2.17, P = 0.004), angina (HR: 1.89, P = 0.037), and beta-blockers (HR: 2.01, P = 0.011). In ms-MIsch group (n = 110), the predictive variable for MACE was ms-SSS (HR: 2.27, P = 0.016). The ms-SSS significantly increases the prognostic value of the ms-MIsch (P = 0.001).

Conclusion: Women with different degrees of abnormal SDS have different PMs of MACE. The ms-SSS stands out as the most significant predictive variable.

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女性不同程度的总和差异灌注评分：对与心脏事件相关的预后变量的影响。

目的评估仅对总和差异评分异常（SDS≥1）、边缘性心肌缺血（borderline-MIsch：SDS=1）、心肌缺血（MIsch：SDS≥2）、轻度心肌缺血（MIsch：SDS=2-4）和中重度心肌缺血（ms-MIsch：SDS≥5）女性的重大心脏不良事件（MACE）预测模型（PM）：2000年1月至2018年1月期间，在25 943名接受门控单光子发射计算机断层扫描心肌灌注成像（gSPECT-MPI）进行冠状动脉风险分层的连续患者中，纳入了717名SDS异常≥1的女性（年龄68.37±3.4岁）。在 gSPECT-MPI 后的随访期间（平均 4 ± 2.9 年），对 MACE（不稳定型心绞痛、非致死性心肌梗死、冠状动脉血运重建、心源性死亡）进行了评估：在全球 SDS 异常的女性队列（n = 717）中，PM 为心绞痛[危险比（HR）：1.65，P = 0.016]、糖尿病（HR：1.72，P = 0.004）、β-受体阻滞剂（HR：1.61，P = 0.009）、药物应激（HR：1.74，P = 0.007）、↓段（ST）mm ≥ 1（HR：1.54，P = 0.039）和中重度异常应激总分（ms-SSS）（HR：2.92，P = 0.001）。在边缘型心肌梗死组（n = 208）中，PM 为既往心肌梗死（HR：3.8，P = 0.001）、硝酸盐（HR：2.13，P = 0.047）、药物应激（HR：4.81，PSDS异常程度不同的女性的MACE PMs也不同。ms-SSS 是最重要的预测变量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nuclear Medicine Communications 医学-核医学

CiteScore

2.20

自引率

6.70%

发文量

212

审稿时长

3-8 weeks

期刊介绍： Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.