TY - JOUR
T1 - The impact of permanent pacemaker implantation on thallium myocardial perfusion examination detecting ischemic heart disease
AU - Huang, Mu Shiang
AU - Chen, Tse Wei
AU - Liu, Yi Sheng
AU - Wang, Yi Shen
AU - Lee, Cheng Han
AU - Chen, Ju Yi
N1 - Funding Information:
The authors would like to thank Convergence CT for assistance with English-language editing of the manuscript and Prof. Ping-Yen Liu for data collection. The authors would like to thank the Ministry of Science and Technology of the Republic of China, Taiwan, for financially supporting this research under contract MOST 108-2218-E-006-019-and MOST 109-2218-E-006-024. M.-S.H. and J.-Y.C.: conception and design. M.-S.H., T.-W.C., Y.-S.L., Y.-S.W., and J.-Y.C.: data acquisition. M.-S.H., T.-W.C., J.-Y.C.: data analysis and interpretation: M.-S.H. and J.-Y.C.: statistical analysis. M.-S.H., T.-W.C., C.-H.L., and J.-Y.C.: drafting and finalizing the article. M.-S.H. and J.-Y.C.: critical revision of the article for important intellectual content.
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - Objectives Patients with permanent pacemaker (PPM) implantation may have altered coronary perfusion patterns that may influence the accuracy of myocardial perfusion examination modalities, which was observed in previous studies but with limited statistic power. Our aim was to examine the performance of thallium-201 (TL-201) myocardial perfusion examination in patients with implanted PPM. Methods Data of consecutive patients from our institution who had coronary angiography examination followed by TL-201 myocardial perfusion examination in pairs within 1 year were collected between January 2010 and December 2016 and were divided into PPM and control groups. Propensity score matching (PSM) was performed to compare the positive predictive value (PPV) of perfusion examinations. Results A total of 934 pairs of studies were evaluated, with 81 in the PPM group and 853 controls. The PPV decreased significantly in the PPM group (28.2 vs. 62.9%, P < 0.001). The finding of large (>20%) ischemic areas correlated significantly with all-cause mortality in the control group (OR, 2.34; P = 0.001), but not in the PPM group (OR,1.05; P = 0.943). After PSM, the PPV was still significantly lower in the PPM group than in the non-PPM group (28.6 vs. 66.2%, P < 0.001). Conclusion Study results do not support the appropriateness of using TL-201 perfusion examinations for risk stratification in patients with implanted PPM. Video Abstract: http://links.lww.com/NMC/A181.
AB - Objectives Patients with permanent pacemaker (PPM) implantation may have altered coronary perfusion patterns that may influence the accuracy of myocardial perfusion examination modalities, which was observed in previous studies but with limited statistic power. Our aim was to examine the performance of thallium-201 (TL-201) myocardial perfusion examination in patients with implanted PPM. Methods Data of consecutive patients from our institution who had coronary angiography examination followed by TL-201 myocardial perfusion examination in pairs within 1 year were collected between January 2010 and December 2016 and were divided into PPM and control groups. Propensity score matching (PSM) was performed to compare the positive predictive value (PPV) of perfusion examinations. Results A total of 934 pairs of studies were evaluated, with 81 in the PPM group and 853 controls. The PPV decreased significantly in the PPM group (28.2 vs. 62.9%, P < 0.001). The finding of large (>20%) ischemic areas correlated significantly with all-cause mortality in the control group (OR, 2.34; P = 0.001), but not in the PPM group (OR,1.05; P = 0.943). After PSM, the PPV was still significantly lower in the PPM group than in the non-PPM group (28.6 vs. 66.2%, P < 0.001). Conclusion Study results do not support the appropriateness of using TL-201 perfusion examinations for risk stratification in patients with implanted PPM. Video Abstract: http://links.lww.com/NMC/A181.
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U2 - 10.1097/MNM.0000000000001319
DO - 10.1097/MNM.0000000000001319
M3 - Article
C2 - 33165253
AN - SCOPUS:85100070306
SN - 0143-3636
VL - 42
SP - 190
EP - 197
JO - Nuclear Medicine Communications
JF - Nuclear Medicine Communications
IS - 2
ER -