• Yosuke Inoue, Daiji Yoshikawa, Hideki Ishii, Satoshi Isobe, Soichiro Kumagai, Susumu Suzuki, Satoshi Okumura, Mutsuharu Hayashi, Tatsuaki Matsubara, Satoru Ohshima, Hiroshi Banno, Kimihiro Komori, Katsuhiko Kato, and Toyoaki Murohara.
• Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
• Circ. J. 2013 Jan 1; 77 (5): 1229-34.

BackgroundAfter abdominal aortic aneurysm (AAA) repair, relatively low survival during long-term follow-up remains an unresolved issue. Stress myocardial perfusion single-photon emission computed tomography (SPECT) well predicts future mortality overall, as well as providing diagnoses of coronary artery disease. The prognostic value of myocardial SPECT findings after AAA repair, however, remains unclear.Methods And ResultsThis study followed 285 patients, all undergoing preoperative pharmacologic stress myocardial perfusion SPECT to determine summed stress score (SSS), then elective AAA repair by open AAA repair or endovascular aneurysm repair. The endpoint of the study was cardiac death. The median follow-up duration was 925 days (range, 541-1,095 days). Twenty-four (8%) died during follow-up. Kaplan-Meier analysis showed that patients with SSS≥9 had a significantly poorer prognosis than those with SSS<9 (76% vs. 93%, P=0.003). Multivariate Cox proportional hazards analysis indicated that SSS≥9, diabetes, and chronic kidney disease≥stage 3 could significantly and independently predict long-term cardiovascular mortality in patients after AAA repair (hazard ratio [HR], 4.2; 95% confidence interval [CI]: 1.8-9.7, P=0.001; HR, 3.0; 95% CI: 1.2-7.4, P=0.020; and HR, 4.1; 95% CI: 1.7-10.1, P=0.029, respectively).ConclusionsPreoperative pharmacologic stress myocardial perfusion SPECT is a useful method to predict long-term cardiovascular mortality for patients undergoing elective AAA repair. 

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