Abstract 15337: The Prevalence of Clinically Significant Ischemia in Patients Undergoing Percutaneous Coronary Intervention, a Report From the Multicenter Registry

Background: Myocardial perfusion scintigraphy (MPS) plays an important role in the evaluation and quantification of myocardial ischemia, and those with significant ischemia (SI) benefit most from revascularization procedures. This study aimed to identify the clinical factors and anatomical features associated with SI in patients with stable ischemic heart disease (SIHD). Methods and Results: Data were analyzed from 4197 SIHD patients undergoing PCI in The Japan Cardiovascular Database (N = 11,258) between September 2008 and April 2013. MPS was used to evaluate 1070 (25.5%) patients. Significant ischemia (SI) was defined as more than 10% ischemic region. Logistic regression analysis was performed to identify any clinical factors associated with SI. Patients with a history of heart failure, stroke, or anginal symptoms with Canadian Cardiovascular Society class 2 or more were more likely to have SI (odds ratio [OR] 1.63, p = 0.025, OR: 1.85, p = 0.009, and OR: 1.49, p = 0.003, respectively). When angiographic variables were considered, a proximal left anterior descending artery (pLAD) lesion was the sole factor associated with SI (OR: 1.46, p = 0.012) (Table). Importantly, those with SI had more complications (p = 0.006), most notably post-PCI infarcts (p = 0.008) (Figure). Conclusions: Patients’ background data, such as stronger anginal symptoms or a pLAD lesion, were associated with SI. Since patients with SI are necessary to be treated with PCI to improve long-term prognosis, however procedure-related complications happen more frequently than non-SI patients. Physicians must give their full attention to the PCI procedure in SI patients to minimize their complication rate.