{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T02:15:05Z","timestamp":1775009705012,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T00:00:00Z","timestamp":1655078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Myocardial perfusion imaging (MPI) is frequently used for cardiac risk assessment before major non\u2010cardiac surgery, but its ability to improve patient risk classification beyond simple clinical assessment is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore the prognostic utility of MPI above a simple clinical risk calculator, the revised cardiac risk index (RCRI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study of at\u2010risk patients who underwent MPI before major non\u2010cardiac surgery in a tertiary hospital was conducted. Major adverse cardiac events (MACE) was defined as any myocardial infarction, acute pulmonary oedema, ventricular arrhythmia or cardiac death within 30 days of surgery. We analysed the predictive value of MPI for MACE using multivariable logistic regression and categorical net reclassification index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>MACE occurred in 47 (7.4%) cases from 635 surgical procedures in 629 patients. MPI\u2010identified medium or large\u2010sized reversible perfusion defects (<jats:italic>P<\/jats:italic> =\u20090.02; odds ratio 2.9; 95% confidence interval 1.1\u20137.1) and RCRI score two or more (<jats:italic>P<\/jats:italic> =\u20090.03; odds ratio 2.3; 95% confidence interval 1.1\u20134.8) were significantly associated with MACE after adjusting for age, coronary revascularisation, surgical priority, need for general anaesthesia, left ventricular ejection fraction (LVEF) and fixed perfusion defects. MPI risk factors (LVEF, reversible perfusion and fixed perfusion defects) did not improve risk classification above baseline risk factors (age, RCRI and surgical priority).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MPI risk factors are weak predictors for early cardiac complications after major non\u2010cardiac surgery and failed to improve patient risk classification beyond essential assessment using age, RCRI and surgical priority. Clinicians should consider alternative risk assessment strategies because of MPI's poor prognostic utility and its associated time and financial costs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.15662","type":"journal-article","created":{"date-parts":[[2021,12,12]],"date-time":"2021-12-12T11:08:15Z","timestamp":1639307295000},"page":"1203-1214","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Myocardial perfusion imaging failed to improve patient risk classification compared with the revised cardiac risk index for early cardiac complications after major non\u2010cardiac surgery"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2226-9062","authenticated-orcid":false,"given":"Yao","family":"Yao","sequence":"first","affiliation":[{"name":"Department of General Medicine Calvary Mater Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Quirk","sequence":"additional","affiliation":[{"name":"Department of Cardiology John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"French","sequence":"additional","affiliation":[{"name":"Department of Cardiology John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0971-7502","authenticated-orcid":false,"given":"Ashok","family":"Dharmalingam","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"Department of Anaesthesia Calvary Mater Hospital  Newcastle New South Wales Australia"},{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Cardiology John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,13]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Australian Institute of Health and Welfare.Australia's hospitals 2016\u201317 at a glance."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1502824"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2010.06478.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000104"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60601-7"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041905"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1401106"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1401105"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.10.1043"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-152-1-201001050-00007"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X211024661"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2016.09.008"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.07.944"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu285"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.126563"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4085"},{"key":"e_1_2_6_18_1","unstructured":"EisukeI.nricens: NRI for Risk Prediction Models with Time to Event and Binary Response Data. 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