Prognostic utility of hybrid coronary computed tomography angiography and myocardial perfusion imaging in elderly patients with suspected coronary artery disease

IF 3.2 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology Pub Date : 2025-06-08 DOI:10.1016/j.ijcard.2025.133493

Wail Nammas , Iina Ajosenpää , Teemu Maaniitty , Iida Stenström , Jeroen J. Bax , Juhani Knuuti , Antti Saraste

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引用次数: 0

Abstract

Background

The prognostic utility of sequential hybrid imaging strategy (coronary computed tomography angiography (CCTA) followed by positron emission tomography (PET) myocardial perfusion imaging in those with obstruction) in the elderly remains unclear. We explored the predictors of adverse outcome in patients ≥65, versus those <65 years, who underwent hybrid CCTA-PET for evaluation of coronary artery disease (CAD).

Methods

Retrospectively, we evaluated 1948 patients (43.8 % ≥65 years) referred for CCTA due to suspected CAD from 2008 through 2016. Patients with obstructive CAD by CCTA (n = 657) underwent ¹⁵O-water PET under adenosine stress.

Results

Mean age was 61.9 ± 9.9 years, 58.9 % were females. Elderly patients had more often obstructive CAD by CCTA, and ischemia by PET. During a median follow-up of 6.7 years, the composite adverse outcome (all-cause death, myocardial infarction, or unstable angina) occurred more often in patients ≥65, versus those <65 years (14.2 % vs. 5.6 %, p < 0.001). Ischemic CAD assessed by hybrid imaging predicted events with a hazard ratio of 5.65 (95 % CI 2.35–13.57) in older patients, and 7.01 (95 % CI 3.08–15.94) in younger patients, compared with patients without CAD. The c-statistic of a multivariable model including the hybrid CCTA-PET finding (adjusted for clinical risk predictors) for predicting the composite outcome was similar between patients ≥65, versus those <65 years (p = 0.1). There was no interaction between age category and the hybrid CCTA-PET finding for prediction of events (p = 0.9).

Conclusion

The prognostic utility of hybrid CCTA-PET for predicting adverse events at long-term follow-up was similar between patients ≥65 and those <65 years.

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冠状动脉计算机断层血管造影与心肌灌注混合成像在老年疑似冠状动脉疾病患者中的预后价值

背景：顺序混合成像策略（冠状动脉计算机断层血管造影（CCTA）与正电子发射断层扫描（PET）心肌灌注成像对梗阻患者）在老年人中的预后应用尚不清楚。我们探讨了≥65岁患者不良结局的预测因素，与以下方法相比：回顾性地，我们评估了1948例患者（43.8% %≥65 岁），从2008年到2016年，由于疑似CAD而转诊CCTA。CCTA诊断的阻塞性CAD患者（n = 657）在腺苷应激下行15O-water PET。结果：平均年龄61.9 ± 9.9 岁，女性58.9 %。老年患者CCTA表现为阻塞性CAD， PET表现为局部缺血。在中位随访6.7 年期间，复合不良结局（全因死亡、心肌梗死或不稳定型心绞痛）在≥65岁的患者中发生的频率高于≥65岁的患者。结论：混合CCTA-PET预测长期随访不良事件的预后效果在≥65岁的患者和≥65岁的患者之间相似

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of cardiology 医学-心血管系统

CiteScore

6.80

自引率

5.70%

发文量

758

审稿时长

44 days

期刊介绍： The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers. In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.