Significance of Coronary Artery Calcifications and Ischemic Electrocardiographic Changes Among Patients Undergoing Myocardial Perfusion Imaging
Authors' conclusion
In patients with normal single-photon emission computed tomography/CT MPI, CAC is strongly associated with adverse outcomes independent of ischemic ECG changes with low event rates in patients without CAC on attenuation CT irrespective of ischemic stress ECG changes.
Study context
- Population
- Patients who underwent exercise treadmill or regadenoson single-photon emission computed tomography/computed tomography (CT) myocardial perfusion imaging (MPI) during June 2016 to May 202247% female, median: 64 (56–73) years
- Participants
- 12,265 patients
- Comparison
- Presence of coronary artery calcification (CAC), with or without ischemic stress electrocardiographic (ECG) changes
- Outcome
- 3-year composite of death, myocardial infarction, or coronary revascularization (MACE)
- Follow-up
- Median 1.6 (IQR: 0.5-3.0) years
Methodological detailslarge academic center
- Large academic center
Main finding
As reported in the abstract
MACE occurred in patients
1,422
Further findings
MACE rate within participants with normal perfusion
3-year composite endpoint by CAC grade (subgroup analysis)
- All CAC grades (mild, moderate, severe) independently associated with worse 3-year composite endpoint rates
MACE by presence of CAC, independent of ischemic ECG changes (multivariable analysis)
- Overall cohort
- P < 0.001
- Patients with normal perfusion
- P < 0.05
- Multivariable analysis
Original publication
Significance of Coronary Artery Calcifications and Ischemic Electrocardiographic Changes Among Patients Undergoing Myocardial Perfusion Imaging. JACC Adv. Published 20 February 2025. doi:10.
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