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Cardiovascular prognosis in patients with preserved left ventricular ejection fraction and no significant ischemia

Authors Furuhashi T, Moroi M

Received 1 March 2017

Accepted for publication 31 May 2017

Published 20 June 2017 Volume 2017:8 Pages 41—48


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 4

Editor who approved publication: Dr Richard Kones

Tatsuhiko Furuhashi, Masao Moroi

Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan

Background: Peripheral artery disease (PAD) and chronic kidney disease (CKD) are important cardiac risk factors, and stress myocardial perfusion imaging (MPI) is widely used as a diagnostic and predictive tool for coronary artery disease (CAD). We evaluated the usefulness of these risk factors for predicting cardiovascular events in patients with low cardiac risk assessed by stress MPI and echocardiography.
Methods: We included 558 patients with suspected or confirmed CAD, a preserved left ventricular ejection fraction ≥50% on echocardiography, and no significant ischemia on stress MPI (summed difference score <2). Follow-up was for 46 months.
Results: Cardiovascular events were observed in 37 patients (6.6%). Multivariate Cox regression analysis indicated that PAD (hazard ratio: 6.62, P<0.001), CKD (hazard ratio: 2.44, P=0.013), and history of CAD (hazard ratio: 2.67, P=0.003) were significant predictors of cardiovascular events. After 48 months’ follow-up, the event rate was significantly higher in patients with a history of CAD than in those without a history of CAD.
Conclusion: In patients with preserved left ventricular ejection fraction and no significant myocardial ischemia, baseline characteristics such as PAD, CKD, and history of CAD can predict cardiac risk.

Keywords: cardiac events, chronic kidney disease, coronary artery disease, left ventricular systolic function, peripheral artery disease, risk factors

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