Prognostic utility of carotid ultrasound and cardiac SPECT imaging in coronary artery bypass patients

摘要

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. MATERIAL AND 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.