Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography
Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography
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DOI：
10.1161/01.cir.0000072790.23090.41
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发表时间：
2003-06-17
期刊：
影响因子：
37.8
通讯作者：
Berman, DS
中科院分区：
文献类型：
--
作者：
Hachamovitch, R;Hayes, SW;Berman, DS
背景：在应激心肌灌注单光子发射计算机断层扫描（心肌灌注应激[MPS]）上出现的诱导缺血量与早期血运重建与药物治疗的短期生存获益之间的关系尚不明确。方法与结果：共随访10 627例连续接受运动或腺苷MPS且既往无心肌梗死或血运重建术的患者（90.6%完成，平均1.9±0.6年）。心源性死亡146例（1.4%）。在MPS定义的亚组后60天内接受治疗，包括血运重建术（671例患者，2.8%死亡率）或药物治疗（9956例患者，1.3%死亡率；P=0.0004）。为了调整治疗的非随机化，使用逻辑回归开发了倾向评分，以模拟参考血运重建的决定。该模型(chi(2)=1822， c指数=0.94，P
Background-The relationship between the amount of inducible ischemia present on stress myocardial perfusion single photon emission computed tomography (myocardial perfusion stress [MPS]) and the presence of a short-term survival benefit with early revascularization versus medical therapy is not clearly defined.Methods and Results-A total of 10 627 consecutive patients who underwent exercise or adenosine MPS and had no prior myocardial infarction or revascularization were followed up (90.6% complete; mean: 1.9+/-0.6 years). Cardiac death occurred in 146 patients (1.4%). Treatment received within 60 days after MPS defined subgroups undergoing revascularization (671 patients, 2.8% mortality) or medical therapy (MT) (9956 patients, 1.3% mortality; P=0.0004). To adjust for nonrandomization of treatment, a propensity score was developed using logistic regression to model the decision to refer to revascularization. This model (chi(2)=1822, c index=0.94, P