학술논문
Incremental Predictive Value of Coronary Calcium Score in Risk Stratification of Coronary Revascularization in Patients With Normal or Mild Ischemia Using Nuclear Myocardial Perfusion Single Photon Emission Computed Tomography
Document Type
Journal Article
Author
Source
Circulation Journal. 2021, 85(6):877
Subject
Language
English
ISSN
1346-9843
1347-4820
1347-4820
Abstract
Methods and Results:We analyzed 528 patients in whom CACS was calculated and who underwent stress MPS within 3 months. Patients with known coronary artery disease, prior coronary revascularization, and those undergoing hemodialysis were excluded. Patients were followed-up with coronary revascularization based on the evidence of physiological ischemia defined by fractional flow reserve or severe coronary stenosis (≥90%). CACS was significantly associated with the summed stress score (SSS) from MPS assessment. Multivariate logistic regression analysis showed that high CACS (≥300; odds ratio [OR] 5.44, 95% confidence interval [CI] 2.28–13.0) and SSS (OR 1.29, 95% CI 1.18–1.40) were significant (P<0.001) predictors of future coronary revascularization. The log-rank test showed that high CACS stratified coronary revascularization in normal SSS (0–3; P<0.001) or mildly abnormal SSS (4–8; P=0.028) groups, whereas high CACS did not significantly stratify coronary revascularization in moderate to severe SSS (≥9; P=0.757).