July 31, 2015PLoS ONEOpen Access

Incremental Diagnostic Performance of Combined Parameters in the Detection of Severe Coronary Artery Disease Using Exercise Gated Myocardial Perfusion Imaging

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Why the study?

Does the combination of treadmill stress test and gSPECT MPI parameters improve the diagnostic detection of severe coronary artery disease in patients referred for exercise MPI?

Population

211 consecutive patients referred for exercise myocardial perfusion imaging between June 2011 and June 2013…

Comparison

Combination of treadmill stress test parameters… vs Individual treadmill or gSPECT parameters alone.

Design

Cohort

Authors

CLChia‐Ju LiuNational Taiwan University Hospital YWYen‐Wen WuChang Gung University of Science and Technology KKKuan‐Yin KoNational Taiwan University

Discussion

Member takes

Implication

May aid severe CAD detection on exercise MPI; hypothesis-generating and requires prospective validation before practice change.

Structured PICO

Does the combination of treadmill stress test and gSPECT MPI parameters improve the diagnostic detection of severe coronary artery disease in patients referred for exercise MPI?

Population

211 consecutive patients referred for exercise myocardial perfusion imaging (MPI) between June 2011 and June 2013 who received invasive coronary angiography within six months. Excluded: history of myocardial infarction (MI), coronary artery bypass grafting, percutaneous coronary intervention, or documented congenital heart disease or severe valvular disease.

Intervention

Combination of treadmill stress test parameters and gated single-photon emission tomography (gSPECT) myocardial perfusion imaging parameters (specifically lung/heart ratio, 3-minute ST depression, and heart rate recovery ratio).

Comparator

Individual treadmill or gSPECT parameters alone (e.g., Summed Stress Score [SSS] or ST/HR ratio).

Outcome

Diagnostic performance (AUC) for detection of severe coronary artery disease (left main ≥ 50% or 3-vessel disease all ≥ 70% luminal stenosis on invasive angiography).surrogate

Combining treadmill stress test parameters with gSPECT myocardial perfusion imaging parameters significantly improves the diagnostic accuracy for detecting severe coronary artery disease compared to using individual parameters alone.

Limitations

Retrospective nature
Small sample size with heterogeneous characteristics
Selection bias (only patients who underwent coronary angiography were included)
High frequency of coronary risk factors limiting generalization

Cite This Study

Liu et al. (2015) studied this question.

synapsesocial.com/papers/6a2124bcf9ede0d10bc3b323 https://doi.org/10.1371/journal.pone.0134485

Topics

Coronary artery disease

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Incremental Diagnostic Performance of Combined Parameters in the Detection of Severe Coronary Artery Disease Using Exercise Gated Myocardial Perfusion Imaging

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Incremental Diagnostic Performance of Combined Parameters in the Detection of Severe Coronary Artery Disease Using Exercise Gated Myocardial Perfusion Imaging

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

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