Relationship Between Noninvasive Coronary Angiography With Multi-slice Computed Tomography and Myocardial Perfusion Imaging
Schuijf JD, et al.
J Am Coll Cardiol, 2006;48(12):2508–14. Epub 2006 Nov 28.
The aim of this study was to perform a head-to-head comparison between multi-slice computed tomography (MSCT), which detects atherosclerosis, and myocardial perfusion imaging (MPI), which detects ischemia, in patients with an intermediate likelihood of coronary artery disease (CAD) and to compare non-invasive findings with invasive coronary angiography. A total of 114 patients, mainly with intermediate likelihood of CAD, underwent both MSCT and MPI. In a subset of 58 patients, invasive coronary angiography was performed. On the basis of the MSCT data, 41 patients were classified as having no CAD, of whom 90% had normal MPI. A total of 33 patients showed non-obstructive CAD, whereas at least one significant lesion was observed in the remaining 40 patients. Only 45% of patients with an abnormal MSCT had abnormal MPI; even in patients with obstructive CAD on MSCT, 50% still had a normal MPI. In the subset of patients undergoing invasive angiography, the agreement with MSCT was excellent (90%). The study concludes that MPI and MSCT provide different and complementary information on CAD, namely, detection of atherosclerosis versus detection of ischemia. Ôûá
Financial Barriers to Healthcare and Outcomes After Acute Myocardial Infarction
Rahimi AR, et al.
This study aimed to measure the baseline prevalence of self-reported financial barriers to healthcare services or medication (as defined by avoidance due to cost) among individuals following acute myocardial infarction (AMI) and their association with subsequent healthcare outcomes. The Prospective Registry Evaluating Myocardial Infarction: Event and Recovery (PREMIER), an observational, multicenter US study of patients with AMI in 2,498 individuals, was employed. Main outcome measures were health status symptoms (Seattle Angina Questionnaire, SAQ), overall health status function (Short Form-12), and rehospitalization. The prevalence of self-reported financial barriers to healthcare services or medication was 18.1% and 12.9%, respectively. Among individuals who reported financial barriers to healthcare services or medication, 68.9% and 68.5%, respectively, were insured. At one-year follow-up, individuals with financial barriers to healthcare services were more likely to have lower SAQ quality-of-life score and increased rates of all-cause and cardiac rehospitalization. Ôûá