Key result
Preoperative myocardial perfusion abnormality independently predicted perioperative cardiac events (RR 4.9, p<0.001) and provided incremental prognostic value in intermediate-risk, but not low-risk, non-cardiac surgery.
Why the study?
Does preoperative risk stratification with myocardial perfusion imaging predict perioperative cardiac events in patients undergoing intermediate and low-risk non-cardiac surgery?
Cohort (n=1,220)
No
Does preoperative risk stratification with myocardial perfusion imaging predict perioperative cardiac events in patients undergoing intermediate and low-risk non-cardiac surgery?
Relative Risk: 4.9
p-value: p=<0.001
Preoperative gated-SPECT provides incremental prognostic value for predicting perioperative cardiac events in patients undergoing intermediate-risk, but not low-risk, non-cardiac surgery.
May support selective perfusion imaging for intermediate-risk non-cardiac surgery; hypothesis-generating and should not yet change practice.
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Hashimoto et al. (2007) conducted a cohort in Intermediate or low-risk non-cardiac surgery (n=1,220). Preoperative myocardial perfusion abnormality on SPECT vs. Normal myocardial perfusion was evaluated on Perioperative cardiac events (cardiac death, non-fatal myocardial infarction, unstable angina, and congestive heart failure) within 1 month after surgery (RR 4.9, p=<0.001). Preoperative myocardial perfusion abnormality independently predicted perioperative cardiac events (RR 4.9, p<0.001) and provided incremental prognostic value in intermediate-risk, but not low-risk, non-cardiac surgery.
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