Association of medical therapies with survival according to SPECT MPI findings
Notice bibliographique
Résumé
Myocardial perfusion imaging (MPI) results in downstream changes to medication prescription. While the benefits of medical therapy for coronary artery disease(CAD) are established, how this varies with MPI findings is unknown. Our goal was to evaluate the association of medical therapy with survival among patients undergoing MPI, including differential associations as a function of imaging findings. Consecutive patients who underwent SPECT MPI for suspected CAD between January 2015 and December 2021 were identified. Multivariable Cox regression modeling was used to assess the associations between medical therapy and all-cause mortality. In total, 7,802 patients were included with mean age 66.1±12.0 and 3841(49.2%) male. Angiotensin converting enzyme inhibitors/angiotensin receptor blockers(ACE/ARBs) were associated with lower mortality (adjusted hazard ratio[HR] 0.79, 95% CI 0.69-0.89, p<0.001). Beta-blockers were not associated with mortality overall (adjusted HR 1.00, 95% CI 0.88-1.13, p=0.995), but were associated with lower mortality among patients with more ischemia (HR 0.94 per summed difference score point, 95% CI 0.90-0.97, p-value <0.001). Statins were associated with greater survival in patients with coronary calcium (adjusted HR 0.73, 95% CI 0.57 – 0.92, p=0.009), but not in patients without coronary calcium (adjusted HR 1.18, 95% CI 0.92 – 1.51 p=0.200). ACE/ARB prescription was significantly associated with improved survival. Beta-blocker prescription was associated with greater survival in patients with ischemia and statins were in patients with coronary calcification. Findings from MPI may identify patients more likely to benefit from specific therapies, suggesting a role for hybrid MPI in guiding medical therapy for CAD. Condensed Abstract:SPECT MPI is commonly used to evaluate suspected CAD and those results influence initiation of medical therapy. We evaluated the associations between medical therapy and all-cause mortality in patients without known CAD undergoing SPECT MPI, including possible effect modification by imaging findings. Patients who were prescribed ACE/ARB therapy experienced improved survival. Statin prescriptions were associated with improved survival in patients with coronary artery calcium and beta-blocker prescriptions were associated with improved survival in patients with ischemia. SPECT MPI not only provides diagnostic value but may also inform patient management to improve patient outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».