Deans' stroke musings: Comparative Predictors of Mortality Risk in Contemporary Patients Referred for Stress Myocardial Perfusion Imaging

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, March 11, 2025

Comparative Predictors of Mortality Risk in Contemporary Patients Referred for Stress Myocardial Perfusion Imaging

I can't imagine a patient could request this test at all. So, pretty much useless.

Comparative Predictors of Mortality Risk in Contemporary Patients Referred for Stress Myocardial Perfusion Imaging

Alan Rozanski, MD^a alan.rozanski@mountsinai.org ∙ Heidi Gransar, MS^b,c ∙ Robert J.H. Miller, MD^d ∙ … ∙ Louise Thomson, MD^b,c ∙ Carl J. Lavie, MD^e ∙ Daniel S. Berman, MD^b,c … Show more

Cite

Abstract

Objective

To assess the relative predictors of mortality risk in a contemporary cohort of patients referred for stress single-photon emission computed tomography myocardial perfusion imaging in whom all relevant risk factors and cardiac-related comorbidities were evaluated at the time of cardiac stress testing.

Methods

We evaluated 15,662 patients undergoing stress single-photon emission computed tomography myocardial perfusion imaging between 2008 and 2017. Patients were observed for a median of 6.7 years for all-cause mortality. Patients were assessed for their mode of stress testing (exercise vs pharmacologic testing), myocardial ischemia, coronary artery disease risk factors, and cardiac-related comorbidities, such as chronic kidney disease.

Results

Age and pharmacologic stress testing, which was performed in 48.1% of our patients, were the most potent predictors of mortality. Moderate to severe myocardial ischemia, a traditional driver of mortality, was present in only 3.6% of patients. There was a stepwise increase in annualized mortality according to patients’ number of risk factors (P < .001) or comorbidities (P < .001). After stratification of patients according to their mode of stress testing, this stepwise relationship of multimorbidity to mortality was noted only in pharmacologically tested patients. By contrast, the annualized mortality risk of patients undergoing treadmill exercise not only was low (<1%/year) but remained so even for patients with a high degree of multimorbidity.

Conclusion

Patients referred for cardiac stress testing manifest a stepwise increase in mortality risk with an increasing burden of coronary artery disease risk factors and concomitant comorbidities. However, this stepwise increase is not observed in patients who perform treadmill exercise at the time of cardiac stress testing.