Effect of changes in perfusion defect size during serial stress myocardial perfusion imaging on cardiovascular outcomes in patients treated with primary percutaneous coronary intervention after myocardial infarction
Effect of changes in perfusion defect size during serial stress myocardial perfusion imaging on cardiovascular outcomes in patients treated with primary percutaneous coronary intervention after myocardial infarction
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连续应激心肌灌注成像期间灌注缺损大小的变化对心肌梗死后直接经皮冠状动脉介入治疗患者心血管结局的影响
DOI：
10.1007/s12350-021-02770-z
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发表时间：
2021
影响因子：
2.4
通讯作者：
W. Acampa
中科院分区：
文献类型：
--
作者：
E. Zampella;T. Mannarino;V. Gaudieri;A. D'Antonio;F. Giallauria;R. Assante;V. Cantoni;R. Green;C. Mainolfi;C. Nappi;A. Genova;M. Petretta;A. Cuocolo;W. Acampa
背景：我们评估了急性心肌梗死（AMI）后接受直接经皮冠状动脉介入治疗（PCI）的患者的系列MPS中灌注缺损大小（PDS）变化的预后价值。方法选择112例AMI后直接PCI患者，分别在1个月内和6个月后接受两次负荷MPS。PDS改善定义为降低≥ 5%。重构定义为左心室（LV）舒张末期容积指数增加≥ 20%。心脏事件包括心源性死亡、非致死性MI、不稳定型心绞痛、反复血运重建和心力衰竭。结果在中位随访86个月期间，发生了22起事件。PDS恶化患者的事件发生率高于PDS不变或改善的患者（P <0.01）。此外，与无重塑的患者相比，有重塑的患者的事件发生率更高（P <0.001）。在考克斯分析中，PDS恶化和重塑是事件的独立预测因素（均P <0.01）。PDS恶化和重构的患者的无事件生存率最差（P <0.001）。结论在AMI后接受直接PCI治疗的患者中，PDS恶化和重构与长期随访时事件风险较高相关。门控负荷MPS改善了这些患者的风险分层。
Background We evaluated the prognostic value of changes in perfusion defect size (PDS) on serial MPS in patients treated with primary percutaneous coronary intervention (PCI) after acute myocardial infarction (AMI). Methods We enrolled 112 patients treated with primary PCI after AMI who underwent two stress MPS within 1 month and after 6 months. Improvement in PDS was defined as a reduction ≥5%. Remodeling was defined as an increase in left ventricular (LV) end-diastolic volume index ≥20%. Cardiac events included cardiac death, nonfatal MI, unstable angina, repeated revascularization, and heart failure. Results During a median follow-up of 86 months, 22 events occurred. Event rate was higher ( P < .01) in patients with worsening of PDS compared to those with unchanged or improved PDS. Moreover, patients with remodeling had a higher ( P < .001) event rate compared to those without. At Cox analysis, worsening of PDS and remodeling resulted independent predictors of events (both P < .01). Patients with both worsening of PDS and remodeling had the worst event-free survival ( P <.001). Conclusion In patients treated with primary PCI after AMI, worsening of PDS and remodeling are associated to higher risk of events at long-term follow-up. Gated stress MPS improves risk stratification in these patients.
DOI：
10.1016/j.ddmec.2007.12.006
发表时间：
2007-01-01
期刊：
Drug discovery today. Disease mechanisms
影响因子：
--
作者：
French, Brent A;Kramer, Christopher M
通讯作者：
Kramer, Christopher M
DOI：
--
发表时间：
1995-11
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
--
作者：
G. Germano;H. Kiat;P. Kavanagh;M. Moriel;M. Mazzanti;H. Su;K. V. Train;D. Berman
通讯作者：
G. Germano;H. Kiat;P. Kavanagh;M. Moriel;M. Mazzanti;H. Su;K. V. Train;D. Berman