Prognostic utility of carotid ultrasound and cardiac SPECT imaging in coronary artery bypass patients.
BACKGROUND
The aim of our study was to evaluate the role of myocardial perfusion imaging (MPI) and common carotid artery intima-media thickness (CCA IMT) in the prognosis of patients with coronary artery disease referred for coronary artery bypass surgery (CABG) in a newly made prognostic model.


METHODS
63 patients (age 60.36 +/- 8.28 years) with angiographically established coronary artery disease referred for CABG were evaluated for: age, smoking, family disposition, dyslipidaemia, arterial hypertension, obesity, diabetes mellitus, previous myocardial infarction and revascularization. Patients underwent nitrate enhanced Gated SPECT myocardial perfusion imaging, with 17-segment analysis for calculation of perfusion scores and viability index. Common carotid artery IMT was measured by B-mode ultrasound. Patients were followed for cardiovascular events 12 months after CABG.


RESULTS
The obtained data reported mean values of left ventricular ejection fraction (LVEF) 46.2 +/- 14.4%, viability index 0.76 +/- 0.55, SRS 17.76 +/- 13.81 and summed nitrate score 12.89 +/- 10.36. Ultrasound detected CCA IMT 0.90 +/- 0.24 mm, with increased value in 67.2% and presence of carotid plaques in 27.1% of pts. We registered 14 events and 8.8% mortality rate. Multiple regression modelling showed bilateral carotid plaque presence as a predictor of total events. Viability index and CCA IMT have been found as independent death predictors.


CONCLUSIONS
Myocardial perfusion viability index and CCA IMT are predictors, independently associated with prognosis of patients referred for CABG.
Bosevski
Marijan
M
Institute for Heart Diseases, Clinical Centre, Skopje, Republic of Macedonia. marijanbosevski@yahoo.com
Peovska
I
I
Maksimovic
J
J
Vavlukis
M
M
Meskovska
S
S
D000368:Aged; D000792:Angiography; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D010477:Perfusion; D011379:Prognosis; D016016:Proportional Hazards Models; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*