Prognostic significance of ST-segment depression during adenosine perfusion imaging
| Autor: | Charles M. Intenzo, Dennis A. Tighe, Joel S. Raichlen, Sung M. Kim, Chan H. Park, David T. Sawyer, Eric A. Brody, Erik S. Marshall |
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| Rok vydání: | 1995 |
| Předmět: |
Male
Technetium Tc 99m Sestamibi medicine.medical_specialty Adenosine Time Factors Perfusion scanning Coronary Disease Electrocardiography Internal medicine Medicine ST segment Humans Myocardial infarction Radionuclide Imaging Aged Proportional Hazards Models ST depression Likelihood Functions Chi-Square Distribution medicine.diagnostic_test business.industry Unstable angina Middle Aged medicine.disease Prognosis Coronary Vessels Thallium Radioisotopes Heart failure Cardiology Exercise Test Female medicine.symptom Cardiology and Cardiovascular Medicine business Perfusion Follow-Up Studies |
| Zdroj: | American heart journal. 130(1) |
| ISSN: | 0002-8703 |
| Popis: | To determine the significance of ST-segment depression during adenosine perfusion imaging for predicting future cardiac events, 188 patients with interpretable electrocardiograms were assessed 1 to 3 years (mean 21.5 ± 6.6 months) after adenosine testing. At least 1 mm of ST-segment depression was observed in 32 (17%) patients, with ≥2 mm of ST-segment depression in 10 (5.3%). Thirty-seven cardiac events occurred during the study period: 2 cardiac deaths, 5 nonfatal myocardial infarctions, 6 admissions for unstable angina, and 24 revascularizations. Univariate predictors of events were a history of congestive heart failure, previous non—Q-wave myocardial infarction, previous coronary angioplasty, use of antianginal medication, ST-segment depression during adenosine infusion (particularly ≥2 mm), any reversible perfusion defect, transient left ventricular cavity dilation, and the severity of perfusion defects. Multivariate analysis identified ≥2 mm ST-segment depression as the most significant predictor of cardiac events (relative risk [RR] = 6.5; p = 0.0001). Other independent predictors of events were left ventricular dilation (RR = 3.8; p = 0.002), previous coronary angioplasty (RR = 3.3; p = 0.001), a history of non—Q-wave myocardial infarction (RR = 2.3; p = 0.01), and the presence of any reversible defect (RR = 2.0; p = 0.05). We conclude that ST-segment depression occurs uncommonly during adenosine infusion, but the presence of ≥2 mm of ST-segment depression is an independent predictor of future cardiac events and provides information in addition to that obtained from clinical variables and the results of adenosine perfusion imaging. |
| Databáze: | OpenAIRE |
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