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New Study Finds Myocardial Perfusion Foretells Poor Results with Prior CABG

In patients who have had a previous CABG, myocardial perfusion predicts poor outcomes.

New Study Finds Myocardial Perfusion Foretells Poor Results with Prior CABG
Image: Human Heart 3D Image | InStyleHealth

According to the results of a study, global stress myocardial blood flow (MBF) and perfusion reserve (MPR) generated from perfusion mapping cardiac magnetic resonance (CMR) are independently predictive of bad outcomes in patients who have had a prior coronary artery bypass graft (CABG).

The existence of regional ischemia on visual assessment and the amount of previous infarction have no effect on this effect, according to the authors.

This retrospective study looked at whether global stress MBF and MPR independently predicted bad outcomes in patients who had previously undergone CABG and were referred for adenosine stress perfusion CMR. The authors used automated MBF quantification to do perfusion mapping.

The primary outcome was a composite of all-cause mortality and major adverse cardiovascular events, which were defined as nonfatal myocardial infarction and unscheduled revascularization. Cox proportional hazards models were used to examine relationships, which were adjusted for comorbidities and CMR characteristics.

The study comprised 341 patients (median age 67 years, 86 percent male), with 81 (24 percent) achieving the primary result after a median follow-up of 638 days (interquartile range 367976).

Stress BMF and MPR independently predicted outcomes after controlling for established prognostic variables (i.e., regional ischemia and infarction). The adjusted hazard ratios for 1 mL/g/min drop in stress MBF were 2.56 (95 percent confidence interval [CI], 1.454.35) and 1.61 (95 percent confidence interval [CI], 1.082.38) for 1 unit decrease in MPR.

"Patients who have had previous CABG surgery often have complicated coronary disease and are still at a significant risk of adverse outcomes," the researchers wrote. "In native vascular disease, quantitative myocardial perfusion measures predict outcomes."

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