Cardiovascular prognosis in patients with preserved left ventricular ejection fraction and no significant ischemia

Background: Peripheral artery disease (PAD) and chronic kidney disease (CKD) are important cardiac risk factors, and stress myocardial perfusion imaging (MPI) is widely used as a diagnostic and predictive tool for coronary artery disease (CAD). We evaluated the usefulness of these risk factors for p...

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Published in:Research reports in clinical cardiology 2017-01, Vol.8, p.41-48
Main Authors: Furuhashi, Tatsuhiko, Moroi, Masao
Format: Article
Language:English
Subjects:
Adenosine
Analysis
Blood pressure
Cardiac events
Cardiovascular disease
Cardiovascular diseases
Chronic kidney disease
Coronary artery
Coronary artery disease
Coronary vessels
Defects
Diabetes
Echocardiography
Fitness equipment
Health risk assessment
Heart attacks
Hypertension
Ischemia
Kidney diseases
Left ventricular function
Left ventricular systolic function
Medical imaging
Mortality
Myocardial perfusion imaging
Patients
Peripheral artery disease
Prognosis
Risk factors
Studies
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Moroi, Masao
description Background: Peripheral artery disease (PAD) and chronic kidney disease (CKD) are important cardiac risk factors, and stress myocardial perfusion imaging (MPI) is widely used as a diagnostic and predictive tool for coronary artery disease (CAD). We evaluated the usefulness of these risk factors for predicting cardiovascular events in patients with low cardiac risk assessed by stress MPI and echocardiography. Methods: We included 558 patients with suspected or confirmed CAD, a preserved left ventricular ejection fraction [greater than or equal to]50% on echocardiography, and no significant ischemia on stress MPI (summed difference score
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We evaluated the usefulness of these risk factors for predicting cardiovascular events in patients with low cardiac risk assessed by stress MPI and echocardiography. Methods: We included 558 patients with suspected or confirmed CAD, a preserved left ventricular ejection fraction [greater than or equal to]50% on echocardiography, and no significant ischemia on stress MPI (summed difference score &lt;2). Follow-up was for 46 months. Results: Cardiovascular events were observed in 37 patients (6.6%). Multivariate Cox regression analysis indicated that PAD (hazard ratio: 6.62, P&lt;0.001), CKD (hazard ratio: 2.44, P=0.013), and history of CAD (hazard ratio: 2.67, P=0.003) were significant predictors of cardiovascular events. After 48 months' follow-up, the event rate was significantly higher in patients with a history of CAD than in those without a history of CAD. Conclusion: In patients with preserved left ventricular ejection fraction and no significant myocardial ischemia, baseline characteristics such as PAD, CKD, and history of CAD can predict cardiac risk. Keywords: cardiac events, chronic kidney disease, coronary artery disease, left ventricular systolic function, peripheral artery disease, risk factors</description><identifier>ISSN: 1179-8475</identifier><identifier>EISSN: 1179-8475</identifier><identifier>DOI: 10.2147/RRCC.S135904</identifier><language>eng</language><publisher>Macclesfield: Dove Medical Press Limited</publisher><subject>Adenosine ; Analysis ; Blood pressure ; Cardiac events ; Cardiovascular disease ; Cardiovascular diseases ; Chronic kidney disease ; Coronary artery ; Coronary artery disease ; Coronary vessels ; Defects ; Diabetes ; Echocardiography ; Fitness equipment ; Health risk assessment ; Heart attacks ; Hypertension ; Ischemia ; Kidney diseases ; Left ventricular function ; Left ventricular systolic function ; Medical imaging ; Mortality ; Myocardial perfusion imaging ; Patients ; Peripheral artery disease ; Prognosis ; Risk factors ; Studies</subject><ispartof>Research reports in clinical cardiology, 2017-01, Vol.8, p.41-48</ispartof><rights>COPYRIGHT 2017 Dove Medical Press Limited</rights><rights>2017. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-2324-8407</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2228662852/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2228662852?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,25753,27924,27925,37012,44590,75126</link.rule.ids></links><search><creatorcontrib>Furuhashi, Tatsuhiko</creatorcontrib><creatorcontrib>Moroi, Masao</creatorcontrib><title>Cardiovascular prognosis in patients with preserved left ventricular ejection fraction and no significant ischemia</title><title>Research reports in clinical cardiology</title><description>Background: Peripheral artery disease (PAD) and chronic kidney disease (CKD) are important cardiac risk factors, and stress myocardial perfusion imaging (MPI) is widely used as a diagnostic and predictive tool for coronary artery disease (CAD). We evaluated the usefulness of these risk factors for predicting cardiovascular events in patients with low cardiac risk assessed by stress MPI and echocardiography. Methods: We included 558 patients with suspected or confirmed CAD, a preserved left ventricular ejection fraction [greater than or equal to]50% on echocardiography, and no significant ischemia on stress MPI (summed difference score &lt;2). Follow-up was for 46 months. Results: Cardiovascular events were observed in 37 patients (6.6%). Multivariate Cox regression analysis indicated that PAD (hazard ratio: 6.62, P&lt;0.001), CKD (hazard ratio: 2.44, P=0.013), and history of CAD (hazard ratio: 2.67, P=0.003) were significant predictors of cardiovascular events. After 48 months' follow-up, the event rate was significantly higher in patients with a history of CAD than in those without a history of CAD. Conclusion: In patients with preserved left ventricular ejection fraction and no significant myocardial ischemia, baseline characteristics such as PAD, CKD, and history of CAD can predict cardiac risk. 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We evaluated the usefulness of these risk factors for predicting cardiovascular events in patients with low cardiac risk assessed by stress MPI and echocardiography. Methods: We included 558 patients with suspected or confirmed CAD, a preserved left ventricular ejection fraction [greater than or equal to]50% on echocardiography, and no significant ischemia on stress MPI (summed difference score &lt;2). Follow-up was for 46 months. Results: Cardiovascular events were observed in 37 patients (6.6%). Multivariate Cox regression analysis indicated that PAD (hazard ratio: 6.62, P&lt;0.001), CKD (hazard ratio: 2.44, P=0.013), and history of CAD (hazard ratio: 2.67, P=0.003) were significant predictors of cardiovascular events. After 48 months' follow-up, the event rate was significantly higher in patients with a history of CAD than in those without a history of CAD. Conclusion: In patients with preserved left ventricular ejection fraction and no significant myocardial ischemia, baseline characteristics such as PAD, CKD, and history of CAD can predict cardiac risk. Keywords: cardiac events, chronic kidney disease, coronary artery disease, left ventricular systolic function, peripheral artery disease, risk factors</abstract><cop>Macclesfield</cop><pub>Dove Medical Press Limited</pub><doi>10.2147/RRCC.S135904</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2324-8407</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adenosine
Analysis
Blood pressure
Cardiac events
Cardiovascular disease
Cardiovascular diseases
Chronic kidney disease
Coronary artery
Coronary artery disease
Coronary vessels
Defects
Diabetes
Echocardiography
Fitness equipment
Health risk assessment
Heart attacks
Hypertension
Ischemia
Kidney diseases
Left ventricular function
Left ventricular systolic function
Medical imaging
Mortality
Myocardial perfusion imaging
Patients
Peripheral artery disease
Prognosis
Risk factors
Studies
title Cardiovascular prognosis in patients with preserved left ventricular ejection fraction and no significant ischemia
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