Key result
Stress myocardial perfusion SPECT provides incremental prognostic value for predicting perioperative cardiac events in patients undergoing intermediate-risk non-cardiac surgery.
Why the study?
Does stress myocardial perfusion SPECT improve preoperative risk stratification for perioperative cardiac events in patients undergoing non-cardiac surgery?
Does stress myocardial perfusion SPECT improve preoperative risk stratification for perioperative cardiac events in patients undergoing non-cardiac surgery?
Stress myocardial perfusion SPECT is a valuable non-invasive imaging tool for preoperative risk stratification in non-cardiac surgery, especially for intermediate-risk procedures and patients with poor functional capacity or diabetes.
May support SPECT for preoperative stratification in intermediate-risk non-cardiac surgery; leaves open need for prospective outcome trials.
It is difficult to assess the likelihood of perioperative cardiac events mainly because of complicated interrelationships between clinical risk and type of surgery. To overcome this problem, The American College of Cardiology/American Heart Association (ACC/AHA) Task Force published guidelines for perioperative cardiovascular evaluation for non-cardiac surgery. The guidelines offer the strategy of preoperative cardiac therapy, operative performance and perioperative management depending on the urgency of surgery, the patient's risk factors, findings of cardiac testing and specific surgical considerations. Non-invasive cardiac testing including myocardial perfusion single-photon emission computed tomography (SPECT) is recommended to be used mainly in patients with poor functional capacity, when the results will affect patient treatment and outcomes. In the current review, we summarized the use of stress myocardial perfusion SPECT referring to previous reports and our data, and provided the tips for indication of SPECT in preoperative risk stratification in non-cardiac surgery.
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Hashimoto et al. (2015) conducted a review in Preoperative risk stratification for non-cardiac surgery. Stress myocardial perfusion SPECT vs. Clinical risk factors alone was evaluated on Perioperative cardiac events. Stress myocardial perfusion SPECT provides incremental prognostic value for predicting perioperative cardiac events in patients undergoing intermediate-risk non-cardiac surgery.
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