• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Early revascularization improves survival in patients with ischemia demonstrated on positron emission tomography perfusion imaging

byJames EnglandandAnees Daud
September 26, 2019
in Cardiology, Chronic Disease, Imaging and Intervention
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. In this study of patients undergoing PET myocardial perfusion imaging, those with greater measured ischemia had improved overall and cardiac survival with early revascularization compared to medical therapy alone.

2. An ischemia threshold of 5% was determined, above which patients were observed to have greater benefit with early coronary revascularization compared to pharmacotherapy.

Evidence Rating Level: 2 (Good)

Study Rundown: For patients with stable coronary artery disease the use of invasive revascularization has not demonstrated any survival or cardiovascular benefit compared to standard medical management. Identifying high-risk patients through myocardial perfusion imaging (MPI) has been one proposed strategy for selecting individuals who may benefit from coronary revascularization. Positron emission tomography (PET) use in MPI evaluation has improved image resolution, lower radiation exposure, improved diagnostic accuracy, and shorter acquisition time compared to standard imaging techniques. The current study sought to evaluate whether PET MPI may identify patients who would benefit from revascularization compared to medical management in a modern cohort. The study found that significant ischemia on PET MPI predicted improved overall and cardiovascular mortality with early revascularization with a threshold ischemia level of 5%.

The current study supports the use of PET MPI for selecting patients at risk for death or major adverse cardiovascular events and suggests a threshold potential ischemia value for which revascularization may be considered. The study is hypothesis generating and results should be confirmed in prospective studies. The main strength of the study is the large contemporary cohort of consecutively undergoing standardized PET MPI testing. The limitations of the study include the single-center, observational design which may influence the outcome with selection bias.

Click to read the study in JACC

Click to read an editorial in JACC

RELATED REPORTS

#VisualAbstract: Functional testing nonsuperior to routine care for percutaneous coronary intervention patients

Functional testing nonsuperior to routine care for percutaneous coronary intervention patients

Fractional flow reserve guidance for percutaneous coronary intervention is similar to intravascular ultrasonography guidance

Relevant Reading: Rates of Referral to Coronary Angiography After Positron Emission Tomography (PET) Myocardial Perfusion Imaging (MPI)

In-Depth [retrospective cohort]: This study is a retrospective cohort of consecutive adult patients who underwent rest and stress rubidium-82 (Rb82) PET MPI within the Saint Luke’s Health System between January 1, 2010, and December 31, 2016. Patients were excluded if they had known cardiomyopathy (EF<40%) or non-diagnostic results. The primary endpoint was all-cause mortality and cardiac mortality was a secondary endpoint. Early revascularization was defined as percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) within 90 days of PET MPI assessment.

A total of 16,029 patients were included in the study with a median follow up of 3.7 years. More than one third (36.8%) of patients had ischemia measurable on PET MPI, and 2,160 patients (13.5%) had more than 10% ischemia. The cohort included 1,107 patients who underwent PCI within 90 days and 170 who had CABG. Patients with greater ischemia had improved survival with early revascularization (P<0.001 for interaction). An ischemia threshold of 5% (with upper limit of 95% CI of 10%) had benefit with early revascularization compared to medical therapy.

Image: PD

©2019 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: Coronary artery diseasemyocardial perfusion imagingPositron Emission Tomography (PET Scan)revascularization
Previous Post

Benefits of high-intensity surveillance following colorectal adenoma removal likely outweigh costs

Next Post

Insulin discontinuation among patients over 75 more common in healthier patients

RelatedReports

#VisualAbstract: Functional testing nonsuperior to routine care for percutaneous coronary intervention patients
StudyGraphics

#VisualAbstract: Functional testing nonsuperior to routine care for percutaneous coronary intervention patients

September 14, 2022
Shorter time to angioplasty may improve heart attack outcomes
Cardiology

Functional testing nonsuperior to routine care for percutaneous coronary intervention patients

September 12, 2022
Colchicine may lower the risk of cardiovascular events in patients with coronary disease
Cardiology

Fractional flow reserve guidance for percutaneous coronary intervention is similar to intravascular ultrasonography guidance

September 1, 2022
Parents desensitized with increasing exposure to movie violence/sex
Cardiology

Unmarried status associated with an increased risk of mortality in Asian populations

June 1, 2022
Next Post
Insulin costs rose exponentially, regardless of formulation or patent

Insulin discontinuation among patients over 75 more common in healthier patients

Quick Take: Risk of rhabdomyolysis with donepezil compared with rivastigmine or galantamine

Quick Take: Risk of rhabdomyolysis with donepezil compared with rivastigmine or galantamine

Pediatric DKA associated with recent acute care visits

Quick Take: Glycemic durability of an early combination therapy with vildagliptin and metformin versus sequential metformin monotherapy in newly diagnosed type 2 diabetes (VERIFY)

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • The Scan by 2 Minute Medicine®: Maternity Leave Left Out, Dry January, A Measles Resurgence, Dr. GPT
  • Former professional football players may be at greater risk of chronic disease
  • Low-dose pirfenidone may be noninferior to standard dosing in patients with idiopathic pulmonary fibrosis
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options