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PET Imaging More Effective than Angiogram for Determining Need for Coronary Stents or Bypass Surgery

By MedImaging International staff writers
Posted on 01 Dec 2022

Most forms of heart disease cause myocardial damage. Myocardial ischemia occurs when blood flow to the heart is reduced, preventing the heart muscle from receiving enough oxygen. When myocardial ischemia affects the deep, or subendocardial, layer of the left ventricular muscle, it is known as subendocardial ischemia. Subendocardial ischemia is commonly diagnosed in patients with cardiovascular disease, but it is not quantified by current imaging tools. The angiogram – an X-ray test that helps doctors evaluate blockages in the arterial system – shows how to do stents or bypass surgery, but not whether those procedures should be done at all.

Now, researchers at The University of Texas Health Science Center at Houston (Houston, TX, USA) have used positron emission tomography (PET) imaging technology to map coronary blood flow and its outcomes – namely, subendocardial ischemia – among patients with heart disease. The new method for determining whether patients with heart disease need coronary stents or bypass surgery is more effective than the angiogram, which is currently used, according to the researchers. The latest study confirmed the findings of their previous research by proving the PET threshold of severity at which stents and bypass surgery improve survival compared to medical treatment alone.

“The cumulative data reveals that all randomized trials of coronary stents and bypass surgery have failed to improve survival after revascularization due to profoundly flawed patient selection based on the angiogram,” said K. Lance Gould, MD, professor and the Martin Bucksbaum Distinguished University Chair in Heart Disease with McGovern Medical School at UTHealth Houston, who was first author on the study and led the team of researchers. “Thus, the coronary angiogram is not the gold standard for determining stents or bypass surgery, but rather, quantitative myocardial perfusion by PET is the gold standard.”

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70 (38.14697265625): select jos_google_plus.link from jos_google_plus where cat=10

71 (36.001205444336): select jos_linkedin.link from jos_linkedin where cat=10

72 (41.961669921875): SELECT fid FROM jos_deeppockets WHERE id=294795528 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294795528 AND published='1' LIMIT 1

73 (39.100646972656): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

74 (279.18815612793): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795528 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (211.00044250488): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795528 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (44.107437133789): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

77 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (58.889389038086): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795528 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (29.087066650391): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795528 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (31.948089599609): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

94 (56.028366088867): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (84.161758422852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

109 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

110 (72.002410888672): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294795528 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (69.141387939453): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294795528 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

113 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

114 (56.028366088867): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294795528 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (560.99891662598): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294795528 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (540.01808166504): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (369.07196044922): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

118 (93.936920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

119 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

120 (115.87142944336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

121 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

122 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

123 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

124 (262.97569274902): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 19396.066665649): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

126 (105.14259338379): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

127 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

128 (458.0020904541): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795528 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795528 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 939848.89984131): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (!!!!! 735209.22660828): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

131 (109.91096496582): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

132 (50.067901611328): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

133 (70.095062255859): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

134 (45.061111450195): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

135 (52.928924560547): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

136 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

137 (501.15585327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (443.93539428711): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (216.00723266602): SELECT name FROM jos_deeppockets WHERE id=215

140 (45.061111450195): SELECT name FROM jos_deeppockets WHERE id=215

141 (652.79006958008): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (619.17304992676): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (!!!!! 3494.9779510498): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

144 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

145 (!!!!! 8212.0895385742): TRUNCATE TABLE jos_trademed_module

146 (!!!!! 2829.0748596191): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294795528 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (718.11676025391): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294795528 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (450.13427734375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (78.201293945312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

151 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

152 (!!!!! 1605.9875488281): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

153 (99.897384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

154 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

155 (!!!!! 1427.8888702393): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795528 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795528 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (56.982040405273): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

157 (37.193298339844): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

158 (46.014785766602): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (155.92575073242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

160 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795528 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795528 AND published='1' LIMIT 1

161 (59.127807617188): select jos_twitters.link from jos_twitters where cat=10

162 (34.093856811523): select jos_facebook.link from jos_facebook where cat=10

163 (33.855438232422): select jos_google_plus.link from jos_google_plus where cat=10

164 (34.093856811523): select jos_linkedin.link from jos_linkedin where cat=10

165 (350.9521484375): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 5753.0403137207): insert into jos_banners_delta values (14615,'2025-05-01 00:46:23','3.137.161.250','view'),(14202,'2025-05-01 00:46:23','3.137.161.250','view'),(14203,'2025-05-01 00:46:23','3.137.161.250','view')

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