Document Detail

Stress cardiac single-photon emission computed tomographic imaging late after coronary artery bypass surgery for risk stratification and estimation of time to cardiac events.
MedLine Citation:
PMID:  18603052     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We assessed predictors and temporal characteristics of cardiac risk in patients undergoing stress single-photon emission computed tomography after coronary artery bypass grafting. METHODS: Stress cardiac tomography was performed in 362 patients 5 years after coronary artery bypass grafting. Cardiac death and myocardial infarction were considered as events. Cox proportional hazards analysis was used to identify predictors of events and parametric survival analysis to predict time to events. RESULTS: During a median follow-up of 27 months, 22 cardiac events occurred (6.1% cumulative event rate). At multivariable Cox analysis, ischemia at cardiac tomography (hazards ratio 3.7, 95% confidence interval 1.5-9.1; P = .004), and diabetes (hazards ratio 3.6, 95% confidence interval 1.5-8.5; P = .006) resulted in independent predictors of events. Event-free survival was 96% in patients with normal cardiac tomography, 86% in those with abnormal tomography without ischemia, and 70% in those with (log-rank 10.6, P for trend = .008). The parametric survival model revealed that the cardiac risk was greater for all time intervals and accelerated more over time in patients with ischemia than in those without (chi(2) 21.4, P < .0001). Patients without diabetes and normal cardiac tomography remained below a defined risk level (5%) for the entire follow-up period. CONCLUSION: Stress cardiac tomography performed 5 years after coronary artery bypass grafting is useful to characterize the risk of cardiac events and its temporal variation. Parametric survival model estimates the predicted time to risk and the level of risk at specific time intervals after coronary artery bypass grafting.
Wanda Acampa; Mario Petretta; Laura Evangelista; Gianantonio Nappi; Luca Luongo; Maria Piera Petretta; Alberto Cuocolo
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-05-07
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  136     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-08     Completed Date:  2008-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-51     Citation Subset:  AIM; IM    
Institute of Biostructures and Bioimages, National Council of Research, Naples, Italy.
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MeSH Terms
Coronary Artery Bypass*
Coronary Artery Disease / epidemiology,  surgery
Death, Sudden, Cardiac / epidemiology,  prevention & control
Diabetes Mellitus / epidemiology
Disease-Free Survival
Exercise Test*
Follow-Up Studies
Middle Aged
Myocardial Infarction / epidemiology,  prevention & control,  radionuclide imaging*,  surgery*
Myocardial Ischemia / epidemiology,  radionuclide imaging*
Postoperative Care / methods*
Recurrence / prevention & control
Risk Assessment
Sex Distribution
Tomography, Emission-Computed, Single-Photon*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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