Preoperative risk stratification with myocardial perfusion imaging in intermediate and low-risk non-cardiac surgery

Jun Hashimoto, Tadaki Nakahara, Jingming Bai, Naoto Kitamura, Tomotaka Kasamatsu, Atsushi Kubo

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Perioperative cardiac risk in high risk surgery is often stratified with myocardial perfusion single-photon emission computed tomography (SPECT). However, little and no data are available about intermediate and low-risk surgery, respectively. Methods and Results: A total of 1,220 consecutive patients underwent electrocardiography-gated dipyridamole stress SPECT to evaluate myocardial perfusion and cardiac function before intermediate or low risk non-cardiac surgery. Variables predictive of perioperative cardiac events were determined and the usefulness of combining pretest information and the incremental prognostic value of SPECT was estimated. The frequency of all cardiac events depended on clinical risk factors and type of surgical procedures. After sorting the patients with clinical risk factors and surgical risk, assessment of myocardial perfusion or cardiac function yielded significant risk stratification in intermediate, but not in low-risk surgery. Adding functional data to perfusion variables offered an incremental prognostic value for patients with an intermediate clinical risk and scheduled intermediate risk surgery. Conclusions: Integrating information about clinical risk factors, type of surgery, myocardial perfusion and cardiac function allows detailed preoperative risk stratification. Preoperative SPECT provides an incremental prognostic value in intermediate, but not in low-risk surgery.

Original languageEnglish
Pages (from-to)1395-1400
Number of pages6
JournalCirculation Journal
Volume71
Issue number9
DOIs
Publication statusPublished - 2007

Fingerprint

Myocardial Perfusion Imaging
Single-Photon Emission-Computed Tomography
Perfusion
Dipyridamole
Electrocardiography

Keywords

  • Gated-single-photon emission tomography
  • Myocardial perfusion
  • Perioperative cardiac event
  • Preoperative risk stratification

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Preoperative risk stratification with myocardial perfusion imaging in intermediate and low-risk non-cardiac surgery. / Hashimoto, Jun; Nakahara, Tadaki; Bai, Jingming; Kitamura, Naoto; Kasamatsu, Tomotaka; Kubo, Atsushi.

In: Circulation Journal, Vol. 71, No. 9, 2007, p. 1395-1400.

Research output: Contribution to journalArticle

Hashimoto, Jun ; Nakahara, Tadaki ; Bai, Jingming ; Kitamura, Naoto ; Kasamatsu, Tomotaka ; Kubo, Atsushi. / Preoperative risk stratification with myocardial perfusion imaging in intermediate and low-risk non-cardiac surgery. In: Circulation Journal. 2007 ; Vol. 71, No. 9. pp. 1395-1400.
@article{61217ef7e8154b32a8f3f396bee2a71c,
title = "Preoperative risk stratification with myocardial perfusion imaging in intermediate and low-risk non-cardiac surgery",
abstract = "Background: Perioperative cardiac risk in high risk surgery is often stratified with myocardial perfusion single-photon emission computed tomography (SPECT). However, little and no data are available about intermediate and low-risk surgery, respectively. Methods and Results: A total of 1,220 consecutive patients underwent electrocardiography-gated dipyridamole stress SPECT to evaluate myocardial perfusion and cardiac function before intermediate or low risk non-cardiac surgery. Variables predictive of perioperative cardiac events were determined and the usefulness of combining pretest information and the incremental prognostic value of SPECT was estimated. The frequency of all cardiac events depended on clinical risk factors and type of surgical procedures. After sorting the patients with clinical risk factors and surgical risk, assessment of myocardial perfusion or cardiac function yielded significant risk stratification in intermediate, but not in low-risk surgery. Adding functional data to perfusion variables offered an incremental prognostic value for patients with an intermediate clinical risk and scheduled intermediate risk surgery. Conclusions: Integrating information about clinical risk factors, type of surgery, myocardial perfusion and cardiac function allows detailed preoperative risk stratification. Preoperative SPECT provides an incremental prognostic value in intermediate, but not in low-risk surgery.",
keywords = "Gated-single-photon emission tomography, Myocardial perfusion, Perioperative cardiac event, Preoperative risk stratification",
author = "Jun Hashimoto and Tadaki Nakahara and Jingming Bai and Naoto Kitamura and Tomotaka Kasamatsu and Atsushi Kubo",
year = "2007",
doi = "10.1253/circj.71.1395",
language = "English",
volume = "71",
pages = "1395--1400",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "9",

}

TY - JOUR

T1 - Preoperative risk stratification with myocardial perfusion imaging in intermediate and low-risk non-cardiac surgery

AU - Hashimoto, Jun

AU - Nakahara, Tadaki

AU - Bai, Jingming

AU - Kitamura, Naoto

AU - Kasamatsu, Tomotaka

AU - Kubo, Atsushi

PY - 2007

Y1 - 2007

N2 - Background: Perioperative cardiac risk in high risk surgery is often stratified with myocardial perfusion single-photon emission computed tomography (SPECT). However, little and no data are available about intermediate and low-risk surgery, respectively. Methods and Results: A total of 1,220 consecutive patients underwent electrocardiography-gated dipyridamole stress SPECT to evaluate myocardial perfusion and cardiac function before intermediate or low risk non-cardiac surgery. Variables predictive of perioperative cardiac events were determined and the usefulness of combining pretest information and the incremental prognostic value of SPECT was estimated. The frequency of all cardiac events depended on clinical risk factors and type of surgical procedures. After sorting the patients with clinical risk factors and surgical risk, assessment of myocardial perfusion or cardiac function yielded significant risk stratification in intermediate, but not in low-risk surgery. Adding functional data to perfusion variables offered an incremental prognostic value for patients with an intermediate clinical risk and scheduled intermediate risk surgery. Conclusions: Integrating information about clinical risk factors, type of surgery, myocardial perfusion and cardiac function allows detailed preoperative risk stratification. Preoperative SPECT provides an incremental prognostic value in intermediate, but not in low-risk surgery.

AB - Background: Perioperative cardiac risk in high risk surgery is often stratified with myocardial perfusion single-photon emission computed tomography (SPECT). However, little and no data are available about intermediate and low-risk surgery, respectively. Methods and Results: A total of 1,220 consecutive patients underwent electrocardiography-gated dipyridamole stress SPECT to evaluate myocardial perfusion and cardiac function before intermediate or low risk non-cardiac surgery. Variables predictive of perioperative cardiac events were determined and the usefulness of combining pretest information and the incremental prognostic value of SPECT was estimated. The frequency of all cardiac events depended on clinical risk factors and type of surgical procedures. After sorting the patients with clinical risk factors and surgical risk, assessment of myocardial perfusion or cardiac function yielded significant risk stratification in intermediate, but not in low-risk surgery. Adding functional data to perfusion variables offered an incremental prognostic value for patients with an intermediate clinical risk and scheduled intermediate risk surgery. Conclusions: Integrating information about clinical risk factors, type of surgery, myocardial perfusion and cardiac function allows detailed preoperative risk stratification. Preoperative SPECT provides an incremental prognostic value in intermediate, but not in low-risk surgery.

KW - Gated-single-photon emission tomography

KW - Myocardial perfusion

KW - Perioperative cardiac event

KW - Preoperative risk stratification

UR - http://www.scopus.com/inward/record.url?scp=34548511351&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548511351&partnerID=8YFLogxK

U2 - 10.1253/circj.71.1395

DO - 10.1253/circj.71.1395

M3 - Article

C2 - 17721017

AN - SCOPUS:34548511351

VL - 71

SP - 1395

EP - 1400

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 9

ER -