title: Post-stress perfusion abnormalities detected on myocardial perfusion single-photon emission computed tomography predict long-term mortality after elective abdominal aortic aneurysm repair.
abstract: BACKGROUND
  After abdominal aortic aneurysm (AAA) repair, relatively low survival during long-term follow-up remains an unresolved issue. Stress myocardial perfusion single-photon emission computed tomography (SPECT) well predicts future mortality overall, as well as providing diagnoses of coronary artery disease. The prognostic value of myocardial SPECT findings after AAA repair, however, remains unclear.
  
  
  RESULTS
  This study followed 285 patients, all undergoing preoperative pharmacologic stress myocardial perfusion SPECT to determine summed stress score (SSS), then elective AAA repair by open AAA repair or endovascular aneurysm repair. The endpoint of the study was cardiac death. The median follow-up duration was 925 days (range, 541-1,095 days). Twenty-four (8%) died during follow-up. Kaplan-Meier analysis showed that patients with SSS≥9 had a significantly poorer prognosis than those with SSS<9 (76% vs. 93%, P=0.003). Multivariate Cox proportional hazards analysis indicated that SSS≥9, diabetes, and chronic kidney disease≥stage 3 could significantly and independently predict long-term cardiovascular mortality in patients after AAA repair (hazard ratio [HR], 4.2; 95% confidence interval [CI]: 1.8-9.7, P=0.001; HR, 3.0; 95% CI: 1.2-7.4, P=0.020; and HR, 4.1; 95% CI: 1.7-10.1, P=0.029, respectively).
  
  
  CONCLUSIONS
  Preoperative pharmacologic stress myocardial perfusion SPECT is a useful method to predict long-term cardiovascular mortality for patients undergoing elective AAA repair.
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Yosuke
authors: Y
authors: Inoue
authors: Daiji
authors: D
authors: Yoshikawa
authors: Hideki
authors: H
authors: Ishii
authors: Satoshi
authors: S
authors: Isobe
authors: Soichiro
authors: S
authors: Kumagai
authors: Susumu
authors: S
authors: Suzuki
authors: Satoshi
authors: S
authors: Okumura
authors: Mutsuharu
authors: M
authors: Hayashi
authors: Tatsuaki
authors: T
authors: Matsubara
authors: Satoru
authors: S
authors: Ohshima
authors: Hiroshi
authors: H
authors: Banno
authors: Kimihiro
authors: K
authors: Komori
authors: Katsuhiko
authors: K
authors: Kato
authors: Toyoaki
authors: T
authors: Murohara
mesh_terms: D000241:Adenosine; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016009:Chi-Square Distribution; D003326:Coronary Circulation; D048909:Diabetes Complications / Q000401:mortality; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures / Q000401:mortality; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality*; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine