Introduction
Methods
Demographics
All (n = 1001) | No revascularization (n = 463) | |||
---|---|---|---|---|
Parameter | Mean (n) | SD | Mean (n) | SD |
Age (years) | 69 | 10 | 70 | 10 |
Sex (male %) | 750 | 75% | 324 | 70% |
Height (cm) | 162 | 9.1 | 162 | 9.3 |
Weight (kg) | 63 | 13 | 63 | 13 |
Body mass index (kg/m2) | 24 | 3.8 | 24 | 3.8 |
Summed stress score | 9.5 | 9.9 | 6.9 | 8.2 |
Summed rest score | 7 | 8.6 | 4.5 | 7.2 |
Summed difference score | 3.3 | 3.9 | 2.9 | 3.2 |
Stress end-diastolic volume | 106 | 40 | 101 | 38 |
Stress ejection fraction | 65 | 13 | 67 | 12 |
Stress end-systolic volume | 40 | 30 | 36 | 27 |
Rest end-diastolic volume | 105 | 38 | 101 | 36 |
Rest ejection fraction | 67 | 13 | 68 | 12 |
Rest end-systolic volume | 37 | 29 | 34 | 26 |
Stress/rest EDV ratio | 1 | 0.096 | 1 | 0.1 |
Stress–Rest ejection fraction | − 1.8 | 6 | − 1.9 | 6.4 |
Diabetes mellitus | 381 | 47% | 158 | 45% |
Hypertension | 606 | 73% | 275 | 73% |
Dyslipidemia | 505 | 65% | 210 | 64% |
CKD (eGFR < 60) | 246 | 32% | 132 | 34% |
Hemodialysis/CAP dialysis | 29 | 3.80% | 14 | 4% |
Current smoking | 154 | 23% | 59 | 24% |
History of smoking | 261 | 41% | 99 | 46% |
Angina pectoris | 236 | 37% | 86 | 39% |
History of myocardial infarction | 205 | 27% | 75 | 16% |
Definition of coronary artery disease
Myocardial perfusion imaging
SPECT data acquisition and processing
Artificial neural network
Defect scoring
Statistics
Results
Univariate analysis to predict MVD
Parameter | χ2 | p | Unit OR | AUC |
---|---|---|---|---|
Age (y) | 0.18 | 0.668 | 1 | 0.532 |
Sex (male) | 15.22 | < 0.0001 | 3.33 | 0.605 |
Height (cm) | 6.11 | 0.014 | 1.03 | 0.586 |
Weight (kg) | 3.67 | 0.056 | 1.02 | 0.573 |
Body mass index (kg/m2) | 0.58 | 0.446 | 1.02 | 0.535 |
Summed stress score | 71.49 | < 0.0001 | 1.16 | 0.793 |
Summed rest score | 57.31 | < 0.0001 | 1.19 | 0.762 |
Summed difference score | 26.82 | < 0.0001 | 1.19 | 0.699 |
Stress end-diastolic volume | 46.49 | < 0.0001 | 1.02 | 0.732 |
Stress ejection fraction | 37.94 | < 0.0001 | 0.94 | 0.682 |
Stress end-systolic volume | 44.45 | < 0.0001 | 1.03 | 0.739 |
Rest end-diastolic volume | 44.65 | < 0.0001 | 1.02 | 0.729 |
Rest ejection fraction | 34.75 | < 0.0001 | 0.94 | 0.668 |
Rest end-systolic volume | 38.34 | < 0.0001 | 1.03 | 0.733 |
Stress/rest EDV ratio | 1.42 | 0.234 | 3.41 | 0.53 |
Stress-Rest ejection fraction | 0.71 | 0.401 | 0.99 | 0.548 |
Diabetes mellitus | 17.57 | < 0.0001 | 3.07 | 0.636 |
Hypertension | 7.98 | 0.005 | 2.59 | 0.581 |
Dyslipidemia | 11.78 | 0.001 | 3.03 | 0.612 |
CKD (eGFR < 60) | 6.52 | 0.011 | 1.88 | 0.574 |
Hemodialysis/CAP dialysis | 0.57 | 0.452 | 1.58 | 0.511 |
Current smoking | 1.47 | 0.225 | 1.51 | 0.539 |
Past smoking | 11.8 | 0.001 | 3.41 | 0.647 |
Angina pectoris | 8.43 | 0.004 | 3.06 | 0.636 |
History of myocardial infarction | 86.79 | < 0.0001 | 15.28 | 0.723 |
Univariate analysis to predict 3VD
Parameter | χ2 | p | Unit OR |
---|---|---|---|
Age (y) | 0.11 | 0.738 | 1.01 |
Sex (male) | 8.47 | 0.004 | 3.67 |
Height (cm) | 2.79 | 0.095 | 1.03 |
Weight (kg) | 4.2 | 0.04 | 1.02 |
Body mass index (kg/m2) | 2.52 | 0.113 | 1.06 |
Summed stress score | 56.64 | < 0.0001 | 1.13 |
Summed rest score | 45.62 | < 0.0001 | 1.13 |
Summed difference score | 22.88 | < 0.0001 | 1.2 |
Stress end-diastolic volume | 22.09 | < 0.0001 | 1.02 |
Stress ejection fraction | 21.37 | < 0.0001 | 0.95 |
Stress end-systolic volume | 23.28 | < 0.0001 | 1.02 |
Rest end-diastolic volume | 22.37 | < 0.0001 | 1.02 |
Rest ejection fraction | 20.3 | < 0.0001 | 0.95 |
Rest end-systolic volume | 20.97 | < 0.0001 | 1.02 |
Stress/rest EDV ratio | 0.09 | 0.768 | 1.5 |
Stress–rest ejection fraction | 0.23 | 0.633 | 0.99 |
Diabetes mellitus | 21.45 | < 0.0001 | 8.36 |
Hypertension | 7.23 | 0.007 | 5.18 |
Dyslipidemia | 7.11 | 0.008 | 3.42 |
CKD (eGFR < 60) | 3.89 | 0.049 | 1.89 |
Hemodialysis/CAP dialysis | 2.25 | 0.134 | 2.78 |
Current smoking | 1.2 | 0.274 | 1.61 |
Past smoking | 8.12 | 0.004 | 4.52 |
Angina pectoris | 6.85 | 0.009 | 5.83 |
History of MI | 63.87 | < 0.0001 | 13.69 |
Comparisons among groups with and without coronary stenosis
Number of stenosis | 0VD | 1VD | 2VD | 3VD | |||||
---|---|---|---|---|---|---|---|---|---|
Items | Mean | SD | Mean | SD | Mean | SD | Mean | SD | P* |
Age (y) | 69.4 | 10.6 | 71 | 9.7 | 68.4 | 9.1 | 70.1 | 7.7 | 0.5001 |
Sex (male) | 178 | 62% | 58 | 81% | 42 | 84% | 46 | 88% | < 0.0001 |
Height (cm) | 160.4 | 9.6 | 162.5 | 9 | 163.5 | 8.7 | 163.6 | 8.3 | 0.0272 |
Weight (kg) | 61.7 | 13.2 | 62.7 | 12.6 | 63.4 | 13.4 | 66.1 | 11.3 | 0.1615 |
Body mass index (kg/m2) | 23.9 | 4 | 23.6 | 3.4 | 23.6 | 3.9 | 24.7 | 3.6 | 0.3996 |
Summed stress score | 3.8 | 3.6 | 8.2 | 8.6 | 12.2 | 9.5 | 17.3 | 12.4 | < 0.0001 |
Summed rest score | 1.9 | 1.8 | 5.6 | 7.7 | 9.1 | 9.6 | 13.1 | 12 | < 0.0001 |
Summed difference score | 2.3 | 2.7 | 3.2 | 3.6 | 3.9 | 3.3 | 5.2 | 4 | < 0.0001 |
Stress EDV | 90.6 | 28.5 | 105.6 | 37.9 | 127 | 47.4 | 125.8 | 45.9 | < 0.0001 |
Stress EF | 69.1 | 10 | 66.2 | 11.5 | 60.1 | 15.3 | 58.8 | 14.6 | < 0.0001 |
Stress ESV | 28.5 | 15.1 | 38.3 | 28.4 | 55.6 | 42.4 | 55.3 | 35.2 | < 0.0001 |
Rest EDV | 91.1 | 27.8 | 106 | 37.4 | 124.7 | 44.2 | 124.9 | 43.2 | < 0.0001 |
Rest EF | 70.8 | 9.4 | 68.2 | 11.7 | 62.6 | 15.6 | 61.1 | 14.3 | < 0.0001 |
Rest ESV | 27.3 | 15.1 | 36.2 | 28.3 | 51.8 | 41.6 | 52.1 | 34.7 | < 0.0001 |
Stress/rest EDV ratio | 1 | 0.1 | 1 | 0.11 | 1 | 0.11 | 1 | 0.1 | 0.5268 |
Stress–rest EF | − 1.7 | 6.8 | − 2 | 5.2 | − 2.4 | 5.7 | − 2.3 | 6.6 | 0.8283 |
Diabetes mellitus | 78 | 38% | 28 | 41% | 19 | 48% | 33 | 85% | < 0.0001 |
Hypertension | 155 | 69% | 50 | 70% | 33 | 79% | 37 | 93% | 0.0149 |
Dyslipidemia | 113 | 57% | 37 | 66% | 28 | 78% | 32 | 84% | 0.0022 |
CKD (eGFR < 60) | 67 | 30% | 24 | 34% | 20 | 43% | 21 | 48% | 0.0669 |
HD/CAP dialysis | 6 | 3% | 4 | 6% | 1 | 3% | 3 | 10% | 0.3213 |
Current smoking | 33 | 21% | 9 | 25% | 8 | 28% | 9 | 32% | 0.5996 |
Past smoking | 48 | 34% | 19 | 70% | 15 | 63% | 17 | 77% | < 0.0001 |
Angina pectoris | 45 | 31% | 20 | 48% | 11 | 52% | 10 | 77% | 0.0019 |
History of MI | 0 | 0% | 23 | 32% | 20 | 40% | 32 | 62% | < 0.0001 |
Multivariate analysis to predict MVD
Parameter | Estimated value | Standard error | χ2 | p | Unit OR |
---|---|---|---|---|---|
Multi-vessel disease | |||||
Intercept | − 4.15 | 0.59 | 49.5 | < 0.0001 | |
SSS | 0.14 | 0.022 | 37.2 | < .0001 | 1.14 |
Rest EDV | 0.010 | 0.0050 | 5.00 | 0.025 | 1.01 |
Hypertension | 0.89 | 0.38 | 5.37 | 0.021 | 2.43 |
3-vessel disease | |||||
Intercept | − 5.25 | 0.75 | 49.0 | < 0.0001 | |
SSS | 0.099 | 0.020 | 23.9 | < 0.0001 | 1.10 |
Diabetes mellitus | 1.57 | 0.49 | 10.5 | 0.0012 | 4.81 |
Hypertension | 1.46 | 0.66 | 4.95 | 0.026 | 4.32 |
0-vessel disease* | |||||
Intercept | 2.29 | 0.33 | 49.1 | < 0.0001 | |
SSS | − 0.16 | 0.029 | 30.9 | < 0.0001 | 0.85 |
Stress ESV | − 0.015 | 0.0079 | 3.50 | 0.061 | 0.99 |
Multiple risk factors (n) | − 0.27 | 0.13 | 4.56 | 0.033 | 0.76 |