Prognostic role of stress-CMR and SPECT-MPI in patients undergoing intermediate-to-high risk non-cardiac surgery

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Data supporting the role stress test myocardial perfusion imaging (MPI) before non-cardiac surgery (NCS) are sparse and out date. In particular, there is no specific evidence on use cardiac magnetic resonance (sCMR) in this setting. The aim present study was to evaluate impact MPI with sCMR single-photon emission computed tomography (SPECT-MPI) surgery-related events. Method single-centre retrospective study, we included all patients CAD or at least two cardiovascular risk factors undergoing intermediate-to-high-risk surgery. After a pre-operative cardiological assessment, including EKG echocardiography, indication perform MPI-stress-test relied clinical judgement cardiologist. Cardiac events occurring within 30 days from were evaluated. A composite primary endpoint infarction, unstable angina, death, cardiogenic shock pulmonary oedema. secondary rate acute coronary syndromes. Results total 1590 included, whom 669 underwent an strategy (287 sCMR, 382 SPECT-MPI). 30-day lower group vs. non-stress (1.2% vs 3.4%; p 0,006; figure 1). Adopting showed significant reduction (OR: 0.334, IC: 0.155 – 0.766, 0.009) syndrome 0.414, 0.174 0.984, 0.046) multivariable analysis. Stress CMR non-inferior SPECT predicting greater accuracy predict artery revascularizations (AUC for sCMR: 0.95 percentage ischemia cut-point 5.5%; 2). Conclusions stress-test associated incidence high-risk candidate complications similarly predicted by SPECT-MPI, although more accurate revascularizations.