Background:
Myocardial perfusion scintigraphy (MPS) plays a pivotal role in the evaluation of ischemia. Coronary computed tomography angiography (CTA) is emerging to evaluate anatomical features for stable ischemic heart disease (SIHD). This study aimed to identify the clinical characteristics of ischemia (MPS) or anatomy (CTA)-oriented percutaneous coronary intervention (PCI) patients for SIHD.
Methods and Results:
Data were analyzed from 4197 SIHD patients undergoing PCI in The Japan Cardiovascular Database (N = 11,258) between September 2008 and April 2013. MPS was used to evaluate 1070 (25.5%) patients. Significant ischemia (SI) was defined as more than 10% ischemic region. CTA was performed in 1433 patients, and patients with ischemia evaluation and unavailable results were excluded. A total of 694 patients (16.5%) were evaluated as CTA group. CTA-oriented PCI patients had milder illness in their background (Table). More than half of patients had multivessel disease (CTA vs non-SI vs SI; 51.6, 66.3, 71.9%). Incomplete revascularization ratio was significantly lower in CTA group (0.6, 2.2, 3.1%, p = 0.003). However, CTA-oriented PCI patients and SI patients had significantly more complications than non-SI patients (6.6, 3.8, 8.2%, p = 0.022), especially post-procedural infarction (2.4, 0.5, 3.0%, p = 0.032) (Figure).
Conclusions:
Even though CTA-oriented PCI patients had incomplete revascularization less frequently, they experienced more complications. These results indicate that functional assessment is important to predict in-hospital complications, and physicians need to give their attention to CTA-oriented PCI patients as well as SI patients.
Association of Target Lesion Characteristics Evaluated by Coronary Computed Tomography Angiography and Plaque Debris Distal Embolization During Percutaneous Coronary Intervention
