Utility of nuclear stress imaging in predicting long-term outcomes one-year post CABG Surgery

Fernando Ortiz, Mackenzi Mbai, Selcuk Adabag, Santiago Garcia, Jennifer Nguyen, Steven Goldman, Herbert B. Ward, Rosemary F. Kelly, Selma Carlson, William L. Holman, Edward O. McFalls

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: 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. Methods: 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. Results: 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). Conclusion: In clinically stable patients early after revascularization with CABG, SPECT-MPI can identify patients at higher risk of heart failure and death.

Original languageEnglish (US)
Pages (from-to)1970-1978
Number of pages9
JournalJournal of Nuclear Cardiology
Issue number6
StatePublished - Dec 2020


  • CAD
  • Exercise testing
  • Heart failure
  • MPI
  • Outcomes research

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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