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 language | English |
|---|---|
| Pages (from-to) | 1395-1400 |
| Number of pages | 6 |
| Journal | Circulation Journal |
| Volume | 71 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 2007 |
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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 journal › Article
}
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 -