Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 29 (4), 222-6

Prognostic Value of Myocardial Perfusion Abnormalities for Long-Term Prognosis in Patients After Coronary Artery Bypass Grafting


Prognostic Value of Myocardial Perfusion Abnormalities for Long-Term Prognosis in Patients After Coronary Artery Bypass Grafting

Irena Milvidaite et al. Indian J Nucl Med.


Aims: The objective was to evaluate the prognostic value of exercise myocardial perfusion scintigraphy (MPS) in patients who underwent coronary artery bypass grafting (CABG).

Subjects and methods: A retrospective, one-center study of 361 patients with multivessel coronary artery disease was carried out. All the patients underwent MPS after CABG due to worsened health status. MPS was performed at 4.5 years standard deviation (SD: 0.2), based on symptoms. MPS was carried out using Tc-99m methoxy isobutyl isonitrile and following a 1-day protocol (stress-rest). The end points were analyzed at 6.5 years (SD: 3.3) after MPS, on the average.

Statistical analysis used: SPSS software for Windows, version 13.0. The t-test or the χ(2)-test was used. Survival times were calculated. A multivariate Cox proportional hazards model was developed.

Results: During the follow-up, death occurred in 54 patients, and 37 patients experienced major adverse cardiovascular events (MACE). In the multivariate analysis, advanced age hazard ratio (HR: 1.45; 95% confidence interval [CI]: 1.4-2.02; P = 0.027), previous myocardial infarction (HR: 3.17; 95% CI: 1.22-8.2; P = 0.018), left ventricular ejection fraction of <40% (HR: 2.16; 95% CI: 1.2-3.89; P = 0.01), and the summed stress score (SSS) of ≥4 (HR: 1.87; 95% CI: 1.02-3.41; P = 0.04) were independent predictors of all-cause death. The summed difference score (SDS) was the only independent predictor of MACE (HR: 1.26; 95% CI: 1.06-1.48; P = 0.034).

Conclusions: The parameters of MPS were found to have prognostic value in the long-term period after CABG. Advanced age, previous myocardial infarction, decreased left ventricular ejection fraction, and the abnormal SSS were associated with an increased risk of all-cause death. The SDS was found to be the only significant risk factor for MACE.

Keywords: Long-term prognosis; myocardial perfusion scintigraphy; myocardial revascularization.

Conflict of interest statement

Conflict of Interest: None declared.


Figure 1
Figure 1
The probability of death, evaluated by proportional hazard model, in patient with both normal and abnormal summed stress score values

Similar articles

See all similar articles


    1. Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS), European Association for Percutaneous Cardiovascular Interventions (EAPCI), Wijns W, Kolh P, Danchin N, Di Mario C, et al. Guidelines on myocardial revascularization. Eur Heart J. 2010;31:2501–55. - PubMed
    1. Zellweger MJ, Lewin HC, Lai S, Dubois EA, Friedman JD, Germano G, et al. When to stress patients after coronary artery bypass surgery? Risk stratification in patients early and late post-CABG using stress myocardial perfusion SPECT: Implications of appropriate clinical strategies. J Am Coll Cardiol. 2001;37:144–52. - PubMed
    1. Acampa W, Petretta MP, Daniele S, Perrone-Filardi P, Petretta M, Cuocolo A. Myocardial perfusion imaging after coronary revascularization: A clinical appraisal. Eur J Nucl Med Mol Imaging. 2013;40:1275–82. - PubMed
    1. Hendel RC, Berman DS, Di Carli MF, Heidenreich PA, Henkin RE, Pellikka PA, et al. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging: A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine. J Am Coll Cardiol. 2009;53:2201–29. - PubMed
    1. Shaw LJ, Iskandrian AE. Prognostic value of gated myocardial perfusion SPECT. J Nucl Cardiol. 2004;11:171–85. - PubMed