@article{26d249b82d154cdd8a4932b0c4501aea,
title = "Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial",
abstract = "BACKGROUND: The relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque characteristics, microvascular disease, coronary vasomotor tone, and genetic factors. Among chronic coronary disease participants with site-determined moderate or severe ischemia, we investigated associations between ischemia severity on stress testing and the extent of CAD on coronary computed tomography angiography. METHODS: Clinically indicated stress testing included nuclear imaging, echocardiography, cardiac magnetic resonance imaging, or nonimaging exercise tolerance test. Among those with preserved renal function who underwent coronary computed tomography angiography, we examined relationships between ischemia and CAD by coronary computed tomography angiography, overall, and by stress test modality, regardless of subsequent randomization. Core laboratories categorized ischemia as severe, moderate, mild, or none, while the extent and severity of anatomic CAD were categorized based on the modified Duke prognostic index. RESULTS: Among 3601 participants with interpretable stress tests and coronary computed tomography angiography, ischemia severity was weakly associated with CAD extent/severity (r=0.27), with modest variability in strength of association by modality: nuclear (n=1532; r=0.40), echocardiography (n=827; r=0.15), cardiac magnetic resonance imaging (n=108; r=0.31), and exercise tolerance test (n=1134; r=0.18). The extent of infarction on nuclear imaging and echocardiography was weakly associated with CAD extent/severity. CONCLUSIONS: Overall, ischemia severity on stress testing showed weak to moderate associations with the anatomic extent of CAD in this cohort with moderate or severe ischemia on local interpretation and controlled symptoms.",
keywords = "angiography, coronary artery disease, infarction, ischemia, plaque, atherosclerotic",
author = "Reynolds, {Harmony R.} and Page, {Courtney B.} and Shaw, {Leslee J.} and Berman, {Daniel S.} and Chaitman, {Bernard R.} and Picard, {Michael H.} and Kwong, {Raymond Y.} and Min, {James K.} and Jonathon Leipsic and Mancini, {G. B.John} and Budoff, {Matthew J.} and Hague, {Cameron J.} and Roxy Senior and Hanna Szwed and Balram Bhargava and Jelena Celutkiene and Milind Gadkari and Bainey, {Kevin R.} and Rolf Doerr and Ramos, {Ruben B.} and Peter Ong and Naik, {Sudhir R.} and Steg, {Philippe Gabriel} and Kaatje Goetschalckx and Chow, {Benjamin J.W.} and Marielle Scherrer-Crosbie and Lawrence Phillips and Mark, {Daniel B.} and Spertus, {John A.} and Alexander, {Karen P.} and O'Brien, {Sean M.} and Boden, {William E.} and Sripal Bangalore and Stone, {Gregg W.} and Maron, {David J.} and Hochman, {Judith S.} and {ISCHEMIA Research Group} and Kreton Mavromatis and Jason Linefsky and Todd Miller and Subhash Banerjee and Newman, {Jonathan D.} and Donnino, {Robert M.} and Muhamed Saric and Khaled Abdul-Nour and Stone, {Peter H.} and Jang, {James J.} and Gennie Yee and Steven Weitz and Suzanne Arnold and O'Keefe, {James Henry} and Shapiro, {Michael D.} and Fein, {Steven A.} and Torosoff, {Mikhail T.} and Radmila Lyubarova and Sulagna Mookherjee and Krzysztof Drzymalski and McFalls, {Edward O.} and Garcia, {Santiago A.} and Bertog, {Stefan C.} and Siddiqui, {Rizwan A.} and Areef Ishani and Hansen, {Ronnell A.} and Khouri, {Michel Georges} and Goldberg, {Jonathan L.} and Richard Goldweit and Cohen, {Ronny A.} and Brooks Mirrer and Victor Navarro and Winchester, {David E.} and Marvin Kronenberg and Christopher McFarren and Heitner, {John F.} and Dauber, {Ira M.} and Charles Cannan and Sriram Sudarshan and Mehta, {Puja K.} and Michael McDaniel and Stamatios Lerakis and Arshed Quyyumi and Wenger, {Nanette K.} and Hedgepeth, {Chester M.} and Heather Hurlburt and Alan Rosen and Zakir Sahul and Steve Leung and Hassan Reda and Khaled Ziada and Sampoornima Setty and Barua, {Rajat S.} and Fadi Hage and Davies, {James E.} and Massoud Leesar and Jaekyeong Heo and Amy Iskandrian and {Al Solaiman}, Firas and Satinder Singh and Khaled Dajani and Mohammad El-Hajjar and {Der Mesropian}, Paul and Joseph Sacco and Brian McCandless and Marisa Orgera and Sidhu, {Mandeep S.} and Imran Arif and Hanan Kerr and Trejo, {Jorge F.} and Gerald Fletcher and Lane, {Gary E.} and Neeson, {Lynn M.} and Parikh, {Pragnesh P.} and Pollak, {Peter M.} and Shapiro, {Brian P.} and Kevin Landolfo and Anthony Gemignani and Daniel O'Rourke and Meadows, {Judith L.} and Call, {Jason T.} and Joseph Hannan and Robert Bojar and Deepti Kumar and John Mukai and Martin, {Edward T.} and Gabriel Vorobiof and Alec Moorman and Scott Kinlay and Hamburger, {Robert J.} and Rocco, {Thomas P.} and Bhatt, {Deepak L.} and Kevin Croce and Quin, {Jacquelyn A.} and Jati Anumpa and Marco Zenati and Faxon, {David P.} and Glenn Rayos and Ashraf Seedhom and Lance Sullenberger and Gregory Kumkumian and Sedlis, {Steven P.} and Donnino, {Robert M.} and Jeffrey Lorin and Tamis-Holland, {Jacqueline E.} and Robert Kornberg and Robert Leber and Souheil Saba and Lee, {Michael W.} and Small, {Delano R.} and Wassim Nona and Alexander, {Patrick B.} and Iram Rehman and Umesh Badami and Kevin Marzo and Robbins, {Inga H.} and Levite, {Howard A.} and Sanjay Shetty and Mayuri Patel and Hamroff, {Glenn S.} and Little, {Raymond W.} and Zimbelman, {Brandi D.} and Lui, {Charles Y.} and Smith, {Brigham R.} and Vezina, {Daniel P.} and Khor, {Lillian L.} and Abraham, {Josephine D.} and Bull, {David A.} and McKellar, {Stephen H.} and David Booth and John Kotter and Ahmed Abdel-Latif and Bob Hu and Labovitz, {Arthur J.} and Michael Berlowitz and Philip Rogal and Fadi Matar and Christiano Caldeira and Fatima Rodriguez and Ingela Schnittger and Fearon, {William F.} and Prakash Deedwania and Kiran Reddy and Joseph Sweeny and Christopher Spizzieri and Hochberg, {Claudia P.} and Salerno, {William D.} and Ray Wyman and Amer Zarka and Shah, {Anil V.} and Thomas Haldis and Kohn, {Jeffrey A.} and Saket Girotra and Omar Almousalli and Krishnam, {Mayil S.} and Milliken, {Jeffrey C.} and Patel, {Pranav M.} and Seto, {Arnold H.} and Harley, {Kevin T.} and Gibson, {Michael A.} and Allen, {Byron J.} and Rita Coram and Sabu Thomas and Schwartz, {Ronald G.} and Wei Chen and {El Shahawy}, Mahfouz and James Stafford and Abernethy, {William B.} and Andrew Zurick and Meyer, {Thomas M.} and Morford, {Ronald G.} and Bruce Rutkin and Sabahat Bokhari and Sokol, {Seth I.} and Jay Meisner and Ihab Hamzeh and Arunima Misra and Matthew Wall and {De Rosen}, {Veronica Lenges} and Mahboob Alam and Turner, {Michael C.} and Mulhearn, {Thomas J.} and Good, {Arnold P.} and Shammas, {Nicolas W.} and Robert Chilton and Nguyen, {Patricia K.} and Matthew Jezior and Gordon, {Paul C.} and Thomas Crain and Robert Stenberg and Pedalino, {Ronald P.} and Joseph Wiesel and Juang, {George J.} and Mohammed Al-Amoodi and David Wohns and Lader, {Ellis W.} and Michael Mumma and McGarvey, {Lekshmi Dharmarajan Joseph F.X.} and Downes, {Thomas R.} and Luckasen, {Gary J.} and Benjamin Cheong and Srinivasa Potluri and Mastouri, {Ronald A.} and Breall, {Jeffery A.} and Revtyak, {George E.} and Bazeley, {Jonathan W.} and Dayuan Li and Kenneth Giedd and Selvanayagam, {Joseph B.} and Joseph, {Majo X.} and James Harrison and Sau Lee and Li Li and Ning Zhang",
year = "2024",
month = dec,
doi = "10.1161/CIRCINTERVENTIONS.123.013743",
language = "English",
volume = "17",
pages = "e013743",
journal = "Circulation: Cardiovascular Interventions",
issn = "1941-7640",
publisher = "American Heart Association",
number = "12",
}
