Risk Assessment

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Justine Cadet, Executive Editor

Two recent studies demonstrated the efficacy of various nuclear cardiology techniques for assessing the risk associated with the extent of ischemia for varied cardiac patient populations.

A study published in August issue of JACC: Cardiovascular Imaging showed that stress cardiac MR (CMR) myocardial perfusion imaging is an effective and robust risk-stratifying tool for patients of either sex presenting with possible ischemia, in addition to avoiding exposure to ionizing radiation with MR.

Compelling evidence indicates that women with coronary artery disease (CAD) experience worse outcomes than men owing to a lack of early diagnosis and management. Thus, Coelho-Filho et al performed stress CMR in 405 patients (168 women, mean age 58 years) referred for ischemia assessment. All patients were followed for major adverse cardiac events (MACE).  

According to the authors, CMR myocardial ischemia score was the strongest multivariable predictor of MACE in this cohort—for both women and men—indicating robust cardiac prognostication regardless of sex.

Likewise, myocardial flow reserve quantified using rubidium-82 (82Rb) PET predicts hard cardiac events and MACE independent of the summed stress score and other parameters, according to research published Aug. 9 in the Journal of the American College of Cardiology.

In the study, Ziadi et al prospectively enrolled 704 consecutive patients; 96 percent completed follow-up (median 387 days). They reported myocardial flow reserve was an independent predictor of hard events (hazard ratio: 3.3) and MACE (hazard ratio: 2.4).

Therefore, the researchers recommended that routine assessment of 82Rb PET-quantified myocardial flow reserve could improve risk stratification for patients being investigated for ischemia. 

Please let us know how you are employing nuclear cardiology techniques to better stratify risk in various cardiac patient populations.

Justine Cadet
jcadet@cardiovascularbusiness.com