Association of coronary revascularisation after physician-referred non-invasive diagnostic imaging tests with outcomes in patients with suspected coronary artery disease: a post hoc subgroup analysis
Objective We aimed to evaluate the association of the prognostic impact of coronary revascularisation with physician-referred non-invasive diagnostic imaging tests (single photon emission CT (SPECT) vs coronary CT angiography) for coronary artery disease.Design A post hoc analysis of a subgroup from...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020-09-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e035111.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841554154222256128 |
|---|---|
| author | Takao Kato Moriaki Inoko Naoya Matsumoto Yukari Uemura Masanao Naya Mitsuru Momose Satoshi Hida Takao Yamauchi Takatomo Nakajima Eriko Suzuki Tohru Shiga Nagara Tamaki |
| author_facet | Takao Kato Moriaki Inoko Naoya Matsumoto Yukari Uemura Masanao Naya Mitsuru Momose Satoshi Hida Takao Yamauchi Takatomo Nakajima Eriko Suzuki Tohru Shiga Nagara Tamaki |
| author_sort | Takao Kato |
| collection | DOAJ |
| description | Objective We aimed to evaluate the association of the prognostic impact of coronary revascularisation with physician-referred non-invasive diagnostic imaging tests (single photon emission CT (SPECT) vs coronary CT angiography) for coronary artery disease.Design A post hoc analysis of a subgroup from the patient cohort recruited for the Japanese Coronary-Angiography or Myocardial Imaging for Angina Pectoris Study.Setting Multiple centres in Japan.Participants From the data of 2780 patients with stable angina, enrolled prospectively between January 2006 and March 2008 in Japan, who had undergone physician-referred non-invasive imaging tests, 1205 patients with SPECT as an initial strategy and 625 with CT as an initial strategy were analysed. We assessed the effect of revascularisation (within 90 days) in each diagnostic imaging stratum and the interaction between the two strata.Primary and secondary outcome measures Major adverse cardiac events (MACEs), including death, myocardial infarction, hospitalisation for heart failure and late revascularisation, were followed up for 1 year. The χ2 test, Student’s t-test, Kaplan-Meier analysis, log-rank test and multivariable Cox proportional hazard model were used in data analysis.Results A total of 210 (17.4%) patients in the SPECT stratum and 149 (23.8%) in the CT stratum underwent revascularisation. Although in each stratum, the cumulative 1 year incidence of MACEs was significantly higher in patients who underwent revascularisation than in those who did not (SPECT stratum: 9.1 vs 1.2%, log-rank p<0.0001; CT stratum: 6.1 vs 0.8%, log-rank p=0.0001), there was no interaction between the risk of revascularisation and the imaging strata (SPECT stratum: adjusted HR (95% CI), 4.25 (1.86–9.72); CT stratum: 4.13 (1.16–14.73); interaction: p=0.97).Conclusion The association of revascularisation with the outcomes of patients with suspected coronary artery disease was not different between SPECT-first and CT-first strategies in a physician-referred fashion. |
| format | Article |
| id | doaj-art-026865ea1672443aaa0b88b09b2e67a6 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-026865ea1672443aaa0b88b09b2e67a62025-01-08T17:25:08ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2019-035111Association of coronary revascularisation after physician-referred non-invasive diagnostic imaging tests with outcomes in patients with suspected coronary artery disease: a post hoc subgroup analysisTakao Kato0Moriaki Inoko1Naoya Matsumoto2Yukari Uemura3Masanao Naya4Mitsuru Momose5Satoshi Hida6Takao Yamauchi7Takatomo Nakajima8Eriko Suzuki9Tohru Shiga10Nagara Tamaki11Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, JapanCardiovascular Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, JapanAcute & Critical Care Center, Nagasaki University Hospital, Nagasaki, JapanBiostatistics Section, Department of Data Science, Center of Clinical Sciences, National Center for Global Health and Medicine, Tokyo, JapanDepartment of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine School of Medicine, Sapporo, Hokkaido, JapanDiagnostic Imaging and Nuclear Medicine, Tokyo Women`s Medical University Toyo Medical Research Center, Shinjuku-ku, Tokyo, JapanDepartment of Cardiology, Tokyo Medical University, Shinjuku-ku, Tokyo, JapanCardiovascular medicine, Japan Community Healthcare Organization Sagamino Hospital, Sagamihara, JapanDepartment of Cardiology, Saitama Cardiovascular and Respiratory Center, Kumagaya-City, JapanDepartment of Nuclear Medicine, Hokkaido University Graduate School of Medicine School of Medicine, Sapporo, Hokkaido, JapanDepartment of Nuclear Medicine, Hokkaido University Graduate School of Medicine School of Medicine, Sapporo, Hokkaido, JapanDepartment of Radiology, Kyoto Prefectural University of Medicine, Kyoto, JapanObjective We aimed to evaluate the association of the prognostic impact of coronary revascularisation with physician-referred non-invasive diagnostic imaging tests (single photon emission CT (SPECT) vs coronary CT angiography) for coronary artery disease.Design A post hoc analysis of a subgroup from the patient cohort recruited for the Japanese Coronary-Angiography or Myocardial Imaging for Angina Pectoris Study.Setting Multiple centres in Japan.Participants From the data of 2780 patients with stable angina, enrolled prospectively between January 2006 and March 2008 in Japan, who had undergone physician-referred non-invasive imaging tests, 1205 patients with SPECT as an initial strategy and 625 with CT as an initial strategy were analysed. We assessed the effect of revascularisation (within 90 days) in each diagnostic imaging stratum and the interaction between the two strata.Primary and secondary outcome measures Major adverse cardiac events (MACEs), including death, myocardial infarction, hospitalisation for heart failure and late revascularisation, were followed up for 1 year. The χ2 test, Student’s t-test, Kaplan-Meier analysis, log-rank test and multivariable Cox proportional hazard model were used in data analysis.Results A total of 210 (17.4%) patients in the SPECT stratum and 149 (23.8%) in the CT stratum underwent revascularisation. Although in each stratum, the cumulative 1 year incidence of MACEs was significantly higher in patients who underwent revascularisation than in those who did not (SPECT stratum: 9.1 vs 1.2%, log-rank p<0.0001; CT stratum: 6.1 vs 0.8%, log-rank p=0.0001), there was no interaction between the risk of revascularisation and the imaging strata (SPECT stratum: adjusted HR (95% CI), 4.25 (1.86–9.72); CT stratum: 4.13 (1.16–14.73); interaction: p=0.97).Conclusion The association of revascularisation with the outcomes of patients with suspected coronary artery disease was not different between SPECT-first and CT-first strategies in a physician-referred fashion.https://bmjopen.bmj.com/content/10/9/e035111.full |
| spellingShingle | Takao Kato Moriaki Inoko Naoya Matsumoto Yukari Uemura Masanao Naya Mitsuru Momose Satoshi Hida Takao Yamauchi Takatomo Nakajima Eriko Suzuki Tohru Shiga Nagara Tamaki Association of coronary revascularisation after physician-referred non-invasive diagnostic imaging tests with outcomes in patients with suspected coronary artery disease: a post hoc subgroup analysis BMJ Open |
| title | Association of coronary revascularisation after physician-referred non-invasive diagnostic imaging tests with outcomes in patients with suspected coronary artery disease: a post hoc subgroup analysis |
| title_full | Association of coronary revascularisation after physician-referred non-invasive diagnostic imaging tests with outcomes in patients with suspected coronary artery disease: a post hoc subgroup analysis |
| title_fullStr | Association of coronary revascularisation after physician-referred non-invasive diagnostic imaging tests with outcomes in patients with suspected coronary artery disease: a post hoc subgroup analysis |
| title_full_unstemmed | Association of coronary revascularisation after physician-referred non-invasive diagnostic imaging tests with outcomes in patients with suspected coronary artery disease: a post hoc subgroup analysis |
| title_short | Association of coronary revascularisation after physician-referred non-invasive diagnostic imaging tests with outcomes in patients with suspected coronary artery disease: a post hoc subgroup analysis |
| title_sort | association of coronary revascularisation after physician referred non invasive diagnostic imaging tests with outcomes in patients with suspected coronary artery disease a post hoc subgroup analysis |
| url | https://bmjopen.bmj.com/content/10/9/e035111.full |
| work_keys_str_mv | AT takaokato associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT moriakiinoko associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT naoyamatsumoto associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT yukariuemura associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT masanaonaya associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT mitsurumomose associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT satoshihida associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT takaoyamauchi associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT takatomonakajima associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT erikosuzuki associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT tohrushiga associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis AT nagaratamaki associationofcoronaryrevascularisationafterphysicianreferrednoninvasivediagnosticimagingtestswithoutcomesinpatientswithsuspectedcoronaryarterydiseaseaposthocsubgroupanalysis |