Prognostic Implication of Perfusion Defect on Contrast Stress Echocardiography after Percutaneous Coronary Intervention

Abstract

Background: The aim of this study was to investigate the prognostic implication of perfusion defect on contrast stress echocardiography (CSE) in patients who underwent percutaneous coronary intervention (PCI). Methods: Between January 2012 and April 2017, patients who underwent CSE after PCI were enrolled in the current study. Perfusion defect (PD) was identified on during pharmacologic stress using intravenous adenosine. Clinical events were evaluated including cardiac death, myocardial infarction (MI), and hospitalization for cardiovascular cause. Results: A total of 137 patients (88 men, 66.7 ± 9.9 years) were enrolled. CSE were performed median 375 days (IQR 345,1117) after PCI. During median follow up of 125 days (IQR 81, 258), 11 patients (8.0%; death 5, MI 1, hospitalization for cardiovascular cause 5) experienced clinical events. No patient experienced critical side effect during CSE. Patients with PD were related with significantly higher incidence of clinical events during stress (19.6% vs. 1.2%, p<0.001). Kaplan-Meier survival curve revealed significant increase of clinical events in patients with PD during stress. After adjusting other confounding variables, stress-PD was independent predictor for clinical events together with atrial fibrillation and low body surface area. Conclusion: Contrast stress echocardiography using adenosine can be used as a prognosticator in patients underwent PCI without the risk of significant side effect.