Document Detail


Assessing clinical impact of myocardial perfusion studies: ischemia or other prognostic indicators?
MedLine Citation:
PMID:  24585107     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
One of the major strengths of nuclear myocardial perfusion imaging (MPI) is the robust prognostic databases from observational studies demonstrating significantly different outcomes in patients with low-risk vs high-risk scans. The severity of the MPI defect can be semi-quantitated using the summed stress score (SSS) and summed difference score (SDS). SSS is more strongly associated with mortality, whereas SDS is the better predictor of subsequent coronary angiography and revascularization. The strength of MPI variables as prognostic indicators decreases when adjusted for prognostically important clinical and stress test variables. Nonetheless, most studies of general patient populations have demonstrated that MPI adds incremental prognostic value to clinical and stress test information. In contrast to these positive results from observational studies, the application of MPI ischemia as a treatment guide in several recent trials (DIAD, WOMEN, COURAGE, BARI 2D, STICH) has largely failed to identify patient subsets with improved outcome. This issue will continue to be investigated in the ongoing PROMISE and ISCHEMIA trials.
Authors:
Todd D Miller; John Wells Askew; Joerg Herrmann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current cardiology reports     Volume:  16     ISSN:  1534-3170     ISO Abbreviation:  Curr Cardiol Rep     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-03-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888969     Medline TA:  Curr Cardiol Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  465     Citation Subset:  IM    
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