Common Test May Not Be Necessary

myocardial perfusion imagingNew research published in the Journal of Nuclear Cardiology has found that it might not be necessary to perform stress testing with myocardial perfusion imaging (MPI) as a component of the pre-operative workup for weight loss surgery candidates. Due to the high prevalence of coronary artery disease (CAD) in the obese population, weight loss surgery candidates are often screened for cardiovascular disease before surgery. A tool commonly used for this screening is stress testing with MPI.

This study set out to decide whether the MPI test is an essential aspect of the weight loss surgery workup. The research team performed 383 consecutive stress MPI studies on patients having a workup before a planned weight loss surgery. One of the key findings was that 2 out of 3 of the patients underwent stress-only imaging, even though overweight and obese patients are often challenging to image. (Stress imaging requires less time, less radiation exposure, and is less expensive than the MPI test). Also, there were very few abnormal MPIs and less than 1% incidence of death overall or incidence of coronary revascularization, and there were no heart attacks. Lastly,  cardiovascular events during the entire surgery period–preoperative through postoperative–were extremely low, even with the increased risk factors for coronary artery disease.

Study author, James Arrighi, M.D., a cardiologist with Rhode Island Hospital, concluded that “the study findings suggest that this patient population is actually at very low risk for cardiovascular events, and if this is truly the case, the normal preoperative stress testing with MPI for the detection of CAD may not have an effect on outcome.”

Image credit Dartmouth Hitchcock Medical Center

Comments are closed.