utility of nuclear stress imaging in predicting long-term outcomes one-year post cabg surgery

Early mpi after cabg is currently considered rarely appropriate in asymptomatic patients. this study aimed to identify prognostic value of nuclear stress-imaging post-cabg. this was a single center prospective study looking at long-term outcomes post-cabg. per protocol participants underwent spect-mpi stress testing and coronary angiogram on the same day, 1-year following cabg. defect size was semi-quantified. the primary outcomes were the composite of death and congestive heart failure. eighty-four participants underwent nuclear stress-imaging and angiography, with a median follow-up of 11.1 years. three separate stress findings predicted the primary outcome: inability to reach stage 3 of a bruce protocol (or 7.3, ci 2.4-22.1, p < 0.001), lvef < 45% (or 4.0, ci 1.1-15.3, p = 0.041) and a moderate-large stress defect size (hr 2.31, ci 1.1-1.5, p = 0.04). these findings appear to be additive and strongest among patients who underwent exercise stress testing (hr 10.6, ci 3.6-30.6, p < 0.001). graft disease was identified in 39 (46%) patients and compared to those individuals with no graft disease, did not predict long-term adverse outcomes (p = 0.29). in clinically stable patients early after revascularization with cabg, spect-mpi can identify patients at higher risk of heart failure and death.