The prevalence of clinically significant ischemia in patients undergoing percutaneous coronary intervention: A report from the multicenter registry

Jun Fujita, Shun Kosaka, Ikuko Ueda, Taku Inohara, Yuichiro Maekawa, Akio Kawamura, Hideaki Kanazawa, Kentaro Hayashida, Ryota Tabei, Shugo Tohyama, Tomohisa Seki, Masahiro Suzuki, Motoaki Sano, Keiichi Fukuda

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background Myocardial perfusion scintigraphy (MPS) plays an important role in the evaluation and quantification of myocardial ischemia, and those with significant ischemia (SI) benefit most from revascularization procedures. This study aimed to identify the clinical factors and anatomical features associated with SI in patients with stable ischemic heart disease (SIHD). Methods and Results Data were analyzed from 4197 SIHD patients undergoing percutaneous coronary intervention (PCI). Ischemia was based on MPS findings prior to PCI, with SI defined as an ischemic region of more than 10% of the total left ventricular area. Logistic regression analysis was performed to identify any clinical factors associated with SI. MPS was used to evaluate 1070 (25.5%) patients pre-procedurally. Patients with a history of heart failure, stroke, or anginal symptoms with Canadian Cardiovascular Society class 2 or more were more likely to have SI (odds ratio [OR] 1.63, p = 0.025, OR: 1.85, p = 0.009, and OR: 1.49, p = 0.003, respectively). When angiographic variables were considered, a proximal left anterior descending artery (pLAD) lesion was the sole factor associated with SI (OR: 1.45, p = 0.012). Importantly, those with SI had more in-hospital complications (p = 0.006), most notably post-PCI infarcts (p = 0.008). Conclusions Patients' background data, such as stronger anginal symptoms or a pLAD lesion, were associated with SI. Patients with SI must be treated with PCI to improve their long-term prognosis; however, procedure-related complications happen more frequently in SI patients than in non-SI patients. Physicians must give their full attention when performing the PCI procedure in SI patients to minimize their complication rate.

Original languageEnglish
Article number133568
JournalPLoS One
Volume10
Issue number7
DOIs
Publication statusPublished - 2015 Jul 31

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Percutaneous Coronary Intervention
ischemia
Registries
Ischemia
Regression analysis
Logistics
odds ratio
scintigraphy
Myocardial Perfusion Imaging
Perfusion Imaging
myocardial ischemia
Odds Ratio
Myocardial Ischemia
lesions (animal)
arteries
signs and symptoms (animals and humans)
Arteries
infarction
heart failure
stroke

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

The prevalence of clinically significant ischemia in patients undergoing percutaneous coronary intervention : A report from the multicenter registry. / Fujita, Jun; Kosaka, Shun; Ueda, Ikuko; Inohara, Taku; Maekawa, Yuichiro; Kawamura, Akio; Kanazawa, Hideaki; Hayashida, Kentaro; Tabei, Ryota; Tohyama, Shugo; Seki, Tomohisa; Suzuki, Masahiro; Sano, Motoaki; Fukuda, Keiichi.

In: PLoS One, Vol. 10, No. 7, 133568, 31.07.2015.

Research output: Contribution to journalArticle

Fujita, Jun ; Kosaka, Shun ; Ueda, Ikuko ; Inohara, Taku ; Maekawa, Yuichiro ; Kawamura, Akio ; Kanazawa, Hideaki ; Hayashida, Kentaro ; Tabei, Ryota ; Tohyama, Shugo ; Seki, Tomohisa ; Suzuki, Masahiro ; Sano, Motoaki ; Fukuda, Keiichi. / The prevalence of clinically significant ischemia in patients undergoing percutaneous coronary intervention : A report from the multicenter registry. In: PLoS One. 2015 ; Vol. 10, No. 7.
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abstract = "Background Myocardial perfusion scintigraphy (MPS) plays an important role in the evaluation and quantification of myocardial ischemia, and those with significant ischemia (SI) benefit most from revascularization procedures. This study aimed to identify the clinical factors and anatomical features associated with SI in patients with stable ischemic heart disease (SIHD). Methods and Results Data were analyzed from 4197 SIHD patients undergoing percutaneous coronary intervention (PCI). Ischemia was based on MPS findings prior to PCI, with SI defined as an ischemic region of more than 10{\%} of the total left ventricular area. Logistic regression analysis was performed to identify any clinical factors associated with SI. MPS was used to evaluate 1070 (25.5{\%}) patients pre-procedurally. Patients with a history of heart failure, stroke, or anginal symptoms with Canadian Cardiovascular Society class 2 or more were more likely to have SI (odds ratio [OR] 1.63, p = 0.025, OR: 1.85, p = 0.009, and OR: 1.49, p = 0.003, respectively). When angiographic variables were considered, a proximal left anterior descending artery (pLAD) lesion was the sole factor associated with SI (OR: 1.45, p = 0.012). Importantly, those with SI had more in-hospital complications (p = 0.006), most notably post-PCI infarcts (p = 0.008). Conclusions Patients' background data, such as stronger anginal symptoms or a pLAD lesion, were associated with SI. Patients with SI must be treated with PCI to improve their long-term prognosis; however, procedure-related complications happen more frequently in SI patients than in non-SI patients. Physicians must give their full attention when performing the PCI procedure in SI patients to minimize their complication rate.",
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T1 - The prevalence of clinically significant ischemia in patients undergoing percutaneous coronary intervention

T2 - A report from the multicenter registry

AU - Fujita, Jun

AU - Kosaka, Shun

AU - Ueda, Ikuko

AU - Inohara, Taku

AU - Maekawa, Yuichiro

AU - Kawamura, Akio

AU - Kanazawa, Hideaki

AU - Hayashida, Kentaro

AU - Tabei, Ryota

AU - Tohyama, Shugo

AU - Seki, Tomohisa

AU - Suzuki, Masahiro

AU - Sano, Motoaki

AU - Fukuda, Keiichi

PY - 2015/7/31

Y1 - 2015/7/31

N2 - Background Myocardial perfusion scintigraphy (MPS) plays an important role in the evaluation and quantification of myocardial ischemia, and those with significant ischemia (SI) benefit most from revascularization procedures. This study aimed to identify the clinical factors and anatomical features associated with SI in patients with stable ischemic heart disease (SIHD). Methods and Results Data were analyzed from 4197 SIHD patients undergoing percutaneous coronary intervention (PCI). Ischemia was based on MPS findings prior to PCI, with SI defined as an ischemic region of more than 10% of the total left ventricular area. Logistic regression analysis was performed to identify any clinical factors associated with SI. MPS was used to evaluate 1070 (25.5%) patients pre-procedurally. Patients with a history of heart failure, stroke, or anginal symptoms with Canadian Cardiovascular Society class 2 or more were more likely to have SI (odds ratio [OR] 1.63, p = 0.025, OR: 1.85, p = 0.009, and OR: 1.49, p = 0.003, respectively). When angiographic variables were considered, a proximal left anterior descending artery (pLAD) lesion was the sole factor associated with SI (OR: 1.45, p = 0.012). Importantly, those with SI had more in-hospital complications (p = 0.006), most notably post-PCI infarcts (p = 0.008). Conclusions Patients' background data, such as stronger anginal symptoms or a pLAD lesion, were associated with SI. Patients with SI must be treated with PCI to improve their long-term prognosis; however, procedure-related complications happen more frequently in SI patients than in non-SI patients. Physicians must give their full attention when performing the PCI procedure in SI patients to minimize their complication rate.

AB - Background Myocardial perfusion scintigraphy (MPS) plays an important role in the evaluation and quantification of myocardial ischemia, and those with significant ischemia (SI) benefit most from revascularization procedures. This study aimed to identify the clinical factors and anatomical features associated with SI in patients with stable ischemic heart disease (SIHD). Methods and Results Data were analyzed from 4197 SIHD patients undergoing percutaneous coronary intervention (PCI). Ischemia was based on MPS findings prior to PCI, with SI defined as an ischemic region of more than 10% of the total left ventricular area. Logistic regression analysis was performed to identify any clinical factors associated with SI. MPS was used to evaluate 1070 (25.5%) patients pre-procedurally. Patients with a history of heart failure, stroke, or anginal symptoms with Canadian Cardiovascular Society class 2 or more were more likely to have SI (odds ratio [OR] 1.63, p = 0.025, OR: 1.85, p = 0.009, and OR: 1.49, p = 0.003, respectively). When angiographic variables were considered, a proximal left anterior descending artery (pLAD) lesion was the sole factor associated with SI (OR: 1.45, p = 0.012). Importantly, those with SI had more in-hospital complications (p = 0.006), most notably post-PCI infarcts (p = 0.008). Conclusions Patients' background data, such as stronger anginal symptoms or a pLAD lesion, were associated with SI. Patients with SI must be treated with PCI to improve their long-term prognosis; however, procedure-related complications happen more frequently in SI patients than in non-SI patients. Physicians must give their full attention when performing the PCI procedure in SI patients to minimize their complication rate.

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