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Preoperative Risk Stratification Using Gated Myocardial Perfusion Studies in Patients with Cancer

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Author(s)
Kiran ChangMona SarkissKyoung Sook WonJoseph SwaffordLyle BroemelingIsis Gayed
Keimyung Author(s)
Won, Kyoung Sook
Department
Dept. of Nuclear Medicine (핵의학)
Journal Title
Journal of Nuclear Medicine
Issued Date
2007
Volume
48
Issue
3
Keyword
risk stratificationcancermyocardial perfusion
Abstract
Cancer patients frequently have anemia or an altered coagulation state that may affect their risk stratification for perioperative cardiac events. We performed this study to investigate the incidence of perioperative cardiac events in cancer patients who had abnormal stress myocardial perfusion imaging (MPI) results versus cancer patients with normal MPI results. Methods: We included 394 consecutive cancer patients with normal (n = 201) or abnormal (n = 193) results on MPI studies performed for preoperative risk stratification. MPI was performed within 6 mo before each patient's scheduled operation. All the patients had surgical procedures requiring general anesthesia, except for 18 who had endoscopic or colonoscopic procedures. We retrospectively reviewed their data for the incidence of major cardiac events intraoperatively and for 1 mo postoperatively. We collected data on their cancer type, risk factors for coronary artery disease, MPI findings, risk of operation, and intraoperative or postoperative major cardiac events, which included death, myocardial infarction (MI), and congestive heart failure (CHF). Results: The patients with abnormal MPI results included 97 with ischemia, 80 with scarring, and 16 with mixed scarring and ischemia. The mean left ventricular ejection fraction and end-diastolic volume were 63.8% ± 9.8% and 82.0 ± 53.5 mL in the normal MPI group versus 52.1% ± 13.1% and 118.1 ± 53.4 mL in the abnormal-MPI group (P < 0.001). There were 9 major intraoperative or postoperative cardiac events (4.7%) in the patients with abnormal MPI results and none in the patients with normal MPI results (P = 0.001). These major events consisted of 3 deaths, 2 acute MIs, 1 non–Q-wave MI, and 3 cases of CHF. Four of these patients had only scarring on their MPI studies, 3 had ischemia, and 2 had scarring and ischemia. Conclusion: Normal MPI results have a high negative predictive value for perioperative cardiac events in cancer patients. Abnormal MPI results, whether demonstrating scarring or ischemia, should prompt appropriate perioperative management in patients with cancer to minimize major cardiac events.
Keimyung Author(s)(Kor)
원경숙
Publisher
School of Medicine
Citation
Kiran Chang et al. (2007). Preoperative Risk Stratification Using Gated
Myocardial Perfusion Studies in Patients
with Cancer. Journal of Nuclear Medicine, 48(3), 344–348.
Type
Article
ISSN
0161-5505
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34195
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학)
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