Abstract 9125: Prognostic Implications of Coronary Revascularization With Diagnostic Imaging Tests

Abstract

Introduction: The differences in the prognostic impact of coronary revascularization with non-invasive diagnostic imaging tests (SPECT versus coronary CT) remain to be elucidated. Hypothesis: We aimed to test the hypothesis that the association of the prognostic impact of coronary revascularization with physician-referred non-invasive diagnostic imaging tests (single photon emission computed tomography [SPECT] versus [vs.] coronary computed tomography (CT) angiography) for coronary artery disease was not different. Methods: From the multicenter data of 2780 patients with stable angina, enrolled prospectively between January 2006 and March 2008 in Japan, who had undergone physician-referred imaging tests, 1205 patients in SPECT as an initial strategy and 625 patients in CT as an initial strategy were analyzed. We assessed the effect of revascularization (within 90 days) in each diagnostic imaging stratum and the interaction between the two strata. Results: A total of 210 (17.4%) patients in the SPECT stratum and 149 (23.8%) in the CT stratum underwent revascularization. Although in each stratum, the cumulative 1-year incidence of MACEs was significantly higher in patients who underwent revascularization 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 revascularization and the imaging strata (SPECT stratum: adjusted hazard ratio [95% confidence interval], 4.25 [1.86-9.72]; CT stratum: 4.13 [1.16-14.73]; interaction: P=0.97). Conclusions: The association of revascularization 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.