Stress testing can help determine which patients are likely
Researchers evaluated 43,443 patients undergoing a stress-rest single-photon emission computed tomography myocardial perfusion imaging. The median follow-up was 11.4 years. Myocardial ischemia was assessed for its interaction between early revascularization and mortality. The frequency of myocardial ischemia varied markedly according to LVEF and angina, ranging from 6.7% among patients with LVEF 55% and no typical angina to 64.0% among patients with LVEF <45% and typical angina (P < 0.001). Among 39,883 patients with LVEF 45%, early revascularization was associated with increased mortality risk among patients without ischemia and lower mortality risk among patients with severe (15%) ischemia. Among 3,560 patients with LVEF <45%, revascularization was not associated with mortality benefit among patients with no or mild ischemia and was associated with decreased mortality among patients with moderate (10%-14%) and severe (15%) ischemia.