Department of Nuclear Medicine, Ankara University Medical School, Ankara, Turkey.
Eur J Nucl Med Mol Imaging. 2022 Feb;49(3):889-894. doi: 10.1007/s00259-021-05552-4. Epub 2021 Sep 7.
To investigate if (i) the risk of ischemia on myocardial perfusion scan (MPS), (ii) number of coronary angiographies (CAG) performed, and (iii) necessity for invasive (stent implantation or coronary artery bypass grafting (CABG)) or medical treatment increased in patients infected with COVID-19.
Patients who were referred to MPS between August 2020 and April 2021 with a history of active symptomatic COVID-19 infection (confirmed by PCR positivity) in the last 6 months were involved in the study group. Age-and gender-matched control group was composed of randomly chosen patients who attended for MPS between January 2019 and September 2019, before pandemic. Frequency of ischemia, CAG, and invasive or medical treatments were compared between groups.
Ischemia was reported more frequently in the study group (p < 0.001). In clinical evaluation, regardless of the MPS results, the necessity for invasive evaluation with CAG and treatment (either medical therapy or invasive interventions) was higher in the study group (p = 0.006 and p = 0.015). It was also true for patients with abnormal MPS results (p = 0.008 and p = 0.024) but not for the patients with ischemia (p = 0.29 and p = 0.06).
There exists a significant increase in the frequency of ischemia on MPS, undergoing CAG, stent implantation or CABG, and initiation of medical therapy in patients with a history of COVID-19 infection in the last 6 months. MPS is a reliable method in patients who present with cardiovascular symptoms in the late COVID period.
研究感染 COVID-19 的患者心肌灌注扫描 (MPS) 出现缺血的风险、进行的冠状动脉造影 (CAG) 数量,以及是否需要进行有创(支架植入或冠状动脉旁路移植术 (CABG))或药物治疗的情况是否增加。
本研究纳入了在过去 6 个月内有活动性 COVID-19 感染(通过 PCR 阳性结果确诊)病史并在 2020 年 8 月至 2021 年 4 月间进行 MPS 的患者,这些患者被纳入研究组。随机选择在疫情前(2019 年 1 月至 9 月)进行 MPS 的患者作为年龄和性别匹配的对照组。比较两组之间缺血、CAG、有创或药物治疗的频率。
研究组报告的缺血更频繁(p<0.001)。在临床评估中,无论 MPS 结果如何,研究组有更高的必要性进行 CAG 有创评估和治疗(药物治疗或有创干预)(p=0.006 和 p=0.015)。对于 MPS 结果异常的患者也是如此(p=0.008 和 p=0.024),但对于缺血患者并非如此(p=0.29 和 p=0.06)。
在过去 6 个月内有 COVID-19 感染史的患者中,MPS 出现缺血、进行 CAG、支架植入或 CABG 以及开始药物治疗的频率显著增加。对于在 COVID 后期出现心血管症状的患者,MPS 是一种可靠的方法。