Association between Cardiovascular Risk Factors and High-risk Features in Myocardial Perfusion Imaging: A Multicenter Study

Hamid Khederlou; Amirali Mohammadi; Maryam Tajik; Mohamad Kazemshiroodi

doi:10.18502/jthc.v18i2.13323

Hamid Khederlou Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Amirali Mohammadi School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Maryam Tajik Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Mohamad Kazemshiroodi Pardis Noor Medical Imaging Center, Department of Nuclear Medicine, Iran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jthc.v18i2.13323

Keywords: Myocardial perfusion imaging; Coronary artery disease; Risk factor

Abstract

Background: Myocardial perfusion imaging (MPI) is a noninvasive method with acceptable sensitivity and specificity in diagnosing coronary artery disease (CAD) in moderate-risk patients, including those with CAD risk factors.

Methods: The present cross-sectional, prospective study was conducted on 4886 patients from April 2020 through March 2023 at Chamran and Tehran Heart Center hospitals. A questionnaire regarding anthropometric variables, demographic characteristics, CAD risk factors, and MPI findings was designed.

Results: Totally, 2179 patients (44.6%) had abnormal MPI. Patients with abnormal MPI were significantly older than those with normal MPI. Older age (OR, 1.64; 95% CI, 1.2 to 1.72; P<0.001), diabetes mellitus (DM) (OR, 1.36; 95% CI, 1.1 to 1.48; P=0.012), hypertension (OR, 1.24; 95% CI, 1.04 to 1.37; P=0.032), and dyslipidemia (OR, 1.54; 95% CI, 1.25 to 1.8; P<0.001) were associated with abnormal MPI independently. Patients with more CAD risk factors were more likely to have abnormal MPI. Thus, in patients without or at most with 1 risk factor and those with 8 CAD risk factors, the likelihood of abnormal MPI was 3.7% and 76.2%, respectively. The frequency of left ventricular dilation and right ventricular prominence was significantly higher in patients with older age (P<0.001 and P=0.043, respectively), dyslipidemia (P<0.001 and P=0.007, respectively), DM (P<0.001 and P<0.001, respectively), and hypertension (P=0.048 and P=0.057, respectively).

Conclusion: Individuals with CAD risk factors, especially those with older age, DM, hypertension, or dyslipidemia, require meticulous attention during CAD evaluation, particularly via MPI.