Poststress left ventricular ejection fraction is an independent predictor of major cardiac events in patients with coronary artery disease and impaired left ventricular function

Aim. The aim of this study was to investigate the prognostic value of myocardial perfusion and function SPECT imaging in patients with coronary artery disease (CAD) and poor left ventricular (LV) function.
Methods. We studied 261 patients (231 men, age 66 10 years) with CAD and a resting IV ejection fraction (LVEF)
Results. During a median follow-up of 31 months, 52 patients (20%) died (35 cardiac deaths), 50 (19%) developed a MACE and 69 (20%) a MACE-HF. In a clinical model, diabetes and angina status were the only predictors of MACE (chi(2) = 19.3; P <0.001). By multivariate analysis, poststress LVEF (chi(2)-gain of 6.4; P=0.008) and presence of ischemia (chi(2)-gain of 5.8; P=0.018) were predictive of MACE. Similarly, diabetes Mellitus (chi(2)=12.1; P <0.001), post-stress LVEF (chi(2)-gain of 5.5; P=0.01.9) and presence of ischemia (chi(2)-gain of 4.3; P=0.044) were independent predictors of MACE-HF. Diabetes inellitus (chi(2)=17.8; P <0.001), presence of angina complaints chi(2)-gain of 6.8; P=0.028) and poststress LVEF (chi(2)-gain of 6.3; P=0.008) were independent predictors of cardiac death or non-fatal myocardial infarction.

Conclusion. In patients with impaired LV function and CAD, poststress LVEF is an independent predictor of future cardiac events.