Online Supplement to Nudi Et Al, Assessment of the Fate of Myocardial Necrosis by Serial

Online supplement to Nudi et al, Assessment of the Fate of Myocardial Necrosis by Serial Myocardial Perfusion Imaging

1

Table 1S. Stress features according to the index myocardial perfusion imaging (MPI).

Feature / Total (N=3961) / Normal MPI (N=543) / Ischemiconly MPI (N=1261) / Ischemic and necrotic MPI (N=474) / Necroticonly MPI
Anynecrosis (N=1413) / Minimalnecrosis (N=409) / Mildnecrosis (N=450) / Moderate necrosis (N=195) / Severe necrosis (N=359) / P
Index MPI
Exercise stress / 3320 (90.0%) / 501 (92.3%) / 1152 (91.4%) / 423 (89.2%) / 1244 (88.0%) / 356 (87.0%) / 400 (88.9%) / 171 (87.7%) / 317 (88.3%) / 0.864
Anginal chest pain during stress / 590 (16.0%) / 23 (4.2%) / 266 (21.1%) / 119 (25.1%) / 182 (12.9%) / 54 (13.2%) / 66 (14.7%) / 21 (10.8%) / 41 (11.4%) / 0.428
% of predicted maximum heart rate / 88.1±7.5 / 90.8±7.1 / 87.5±7.7 / 86.8±7.4 / 88.1±7.2 / 88.2±7.2 / 88.1±6.9 / 88.3±7.2 / 87.9±7.4 / 0.915
Metabolic Equivalents of Task / 12.8±4.84 / 12.5±5.4 / 12.9±4.8 / 12.4±4.5 / 13.1±4.8 / 13.5±4.9 / 13.1±4.7 / 12.9±4.8 / 12.3±4.5 / <0.001
ST-segment deviation (mm) / 1.79±1.99 / 0.89±1.68 / 2.14±1.97 / 1.96±2.02 / 1.26±1.93 / 1.15±1.94 / 1.43±2.06 / 0.97±1.62 / 1.30±1.91 / 0.626
Left ventricular ejection fraction (%) / 53.3±11.9 / 65.2±9.9 / 56.2±9.9 / 44.6±9.8 / 49.0±10.5 / 56.9±8.5 / 51.6±7.5 / 46.5±7.6 / 38.3±7.1 / <0.001
End-diastolic volume index (mm/m2) / 88.0±41.9 / 58.9±19.5 / 77.6±29.3 / 113.6±49.3 / 99.8±45.7 / 79.8±29.1 / 85.2±29.6 / 100.1±34.7 / 141.0±55.6 / <0.001
Months between index and serial MPS / 29.0±20.6 / 32.4±21.2 / 27.7±20.6 / 25.6±19.6 / 29.9±20.4 / 30.1±21.3 / 28.8±19.0 / 30.8±20.2 / 30.7±21.0 / 0.517
Serial MPI
Exercise stress / 3198 (86.6%) / 489 (90.1%) / 1123 (89.1%) / 401 (84.6%) / 1185 (83.9%) / 336 (82.2%) / 390 (86.7%) / 164 (84.1%) / 295 (82.2%) / 0.234
Anginal chest pain during stress / 736 (20.0%) / 84 (15.5%) / 278 (22.1%) / 121 (25.5%) / 253 (18.0%) / 68 (16.7%) / 87 (19.5%) / 41 (21.0%) / 57 (16.0%) / 0.345
% of predicted maximum heart rate / 88.1±8.0 / 90.2±8.7 / 87.5±8.2 / 87.4±7.7 / 87.9±7.4 / 88.3±7.3 / 88.4±7.4 / 88.2±7.3 / 86.8±7.5 / 0.022
Metabolic Equivalents of Task / 13.4±4.72 / 13.2±5.1 / 13.6±4.7 / 12.5±4.2 / 13.7±4.7 / 14.0±4.7 / 13.9±4.7 / 14.0±4.8 / 12.9±4.7 / <0.001
ST-segment deviation (mm) / 1.79±1.99 / 1.13±1.82 / 1.77±1.98 / 1.74±2.02 / 1.18±1.83 / 1.38±2.03 / 1.15±1.74 / 1.17±1.88 / 0.94±1.62 / 0.480
Left ventricular ejection fraction (%) / 55.1±12.3 / 67.0±10.0 / 58.9±9.8 / 46.4±9.8 / 49.9±11.0 / 58.4±9.2 / 52.4±8.1 / 46.9±.6 / 39.0±7.6 / <0.001
End-diastolic volume index (mm/m2) / 82.7±43.3 / 55.7±20.1 / 69.9±26.9 / 107.1±51.4 / 96.4±49.1 / 75.5±29.4 / 82.0±30.4 / 97.7±36.6 / 138.0±64.4 / <0.001
Comparison of index and serial MPS
Decrease in chest pain / 338 (9.2%) / 14 (2.6%) / 148 (11.7%) / 63 (13.3%) / 113 (8.0%) / 34 (8.3%) / 37 (8.2%) / 12 (6.2%) / 30 (8.4%) / 0.789
Increase in % of predicted maximum heart rate / -0.05±7.93 / -0.25±7.64 / -0.03±7.95 / 0.55±7.95 / 0.04±7.23 / 0.04±7.23 / 0.29±7.79 / 0.07±8.47 / -1.24±8.34 / 0.080
Increase in Metabolic Equivalent of Task (MET) / 0.15±4.20 / 0.38±4.00 / 0.34±4.27 / -0.18±4.21 / -0.01±4.18 / 0.04±3.89 / 0.01±4.20 / 0.11±4.40 / -0.18±4.35 / 0.201
Decrease in ST-segment deviation (mm) / 0.00±2.58 / -0.76±1.98 / 0.23±2.60 / -0.04±2.64 / -0.21±2.66 / -0.43±2.89 / 0.07±2.87 / -0.61±1.72 / -0.13±2.29 / 0.717
Increase in LVEF (%) / 1.8±5.9 / 1.9±6.7 / 2.7±6.6 / 1.8±5.5 / 0.9±4.9 / 1.4±5.8 / 0.8±5.0 / 0.4±4.8 / 0.7±3.7 / 0.053
Decrease in LVEDVI (mm/m2) / 5.3±21.0 / 3.3±12.4 / 7.8±17.1 / 6.9±26.4 / 3.4±24.2 / 4.1±18.6 / 3.3±20.3 / 2.5±21.2 / 3.2±33.9 / 0.884

LVEDVI=end-diastolic volume index; LVEF=left ventricular ejection fraction; MET=Metabolic Equivalent of Task

Table 2S. Patient-level comparison between index and serial myocardial perfusion imaging (MPI) highlighting changes in the prevalence of necrosis according to according to medical therapy versus intervening percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

Patients (N=3691) / Serial MPI
Normal (N=544) / Ischemia (N=1249) / Ischemia and necrosis / Necrosis
Minimal necrosis (N=97) / Mild necrosis (N=145) / Moderate necrosis (N=94) / Severe necrosis (N=118) / Minimal necrosis (N=406) / Mild necrosis (N=479) / Moderate necrosis (N=207) / Severe necrosis (N=352)
Index MPI / Normal (N=543) / Medical therapy (N=495) / 336 (67.9%) / 145 (29.3%) / 1 (0.2%) / 0 / 0 / 0 / 13 (2.6%) / 0 / 0 / 0
PCI (N=42) / 19 (45.2%) / 20 (47.6%) / 0 / 0 / 0 / 1 (2.4%) / 2 (4.8%) / 1 (2.4%) / 0 / 0
CABG (N=6) / 4 (66.7%) / 2 (33.3%) / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
Ischemia (N=1261) / Medical therapy (N=859) / 102 (11.9%) / 597 (69.5%) / 22 (2.6%) / 13 (1.5%) / 9 (1.1%) / 1 (0.1%) / 66 (7.7%) / 44 (5.1%) / 1 (0.1%) / 1 (0.1%)
PCI (N=323) / 34 (10.5%) / 204 (63.2%) / 11 (3.4%) / 8 (2.5%) / 4 (1.2%) / 0 / 42 (13.0%) / 19 (5.9%) / 0 / 1 (0.3%)
CABG (N=79) / 11 (13.9%) / 39 (49.4%) / 3 (3.8%) / 3 (3.8%) / 1 (1.3%) / 0 / 7 (8.9%) / 13 (16.5%) / 2 (2.5%) / 0
Ischemia and necrosis (N=474) / Minimal necrosis (N=85) / Medical therapy (N=84) / 0 / 10 (11.9%) / 3 (3.6%) / 1 / 3 (3.6%) / 0 / 7 (8.3%) / 25 (29.8%) / 0 / 0
PCI (N=25) / 1 (4.0%) / 12 (48.0%) / 6 (24.0%) / 0 / 0 / 0 / 5 (20.0%) / 1 (4.0%) / 0 / 0
CABG (N=7) / 1 (14.3%) / 3 (42.9%) / 1 (14.3%) / 0 / 0 / 0 / 1 (14.3%) / 1 (14.3%) / 0 / 0
Mild necrosis (N=146) / Medical therapy (N=84) / 0 / 10 (11.9%) / 3 (3.6%) / 36 (42.9%) / 3 (3.6%) / 0 / 7 (8.3%) / 25 (29.8%) / 0 / 0
PCI (N=52) / 0 / 10 (19.2%) / 5 (9.6%) / 13 (25.0%) / 2 (3.9%) / 0 / 5 (9.6%) / 14 (26.9%) / 3 (5.8%) / 0
CABG (N=10) / 0 / 0 / 0 / 1 (10.0%) / 0 / 0 / 2 (20.0%) / 6 (60.0%) / 1 (10.0%) / 0
Moderate necrosis (N=93) / Medical therapy (N=61) / 0 / 3 (4.9%) / 0 / 8 (13.1%) / 26 (42.6%) / 5 (8.2%) / 0 / 6 (9.8%) / 12 (19.7%) / 1 (1.6%)
PCI (N=25) / 0 / 2 (8.0%) / 0 / 0 / 10 (40.0%) / 3 (12.0%) / 0 / 4 (16.0%) / 4 (16.0%) / 2 (8.0%)
CABG (N=7) / 0 / 1 (14.3%) / 0 / 0 / 1 (14.3%) / 1 (14.3%) / 0 / 2 (28.6%) / 2 (28.6%) / 0
Severe necrosis (N=150) / Medical therapy (N=84) / 0 / 1 (1.2%) / 0 / 0 / 3 (3.6%) / 40 (47.6%) / 0 / 4 (4.8%) / 5 (6.0%) / 31 (36.9%)
PCI (N=51) / 0 / 1 (2.0%) / 0 / 0 / 2 (3.9%) / 20 (39.2%) / 0 / 1 (2.0%) / 3 (5.9%) / 24 (47.1%)
CABG (N=15) / 0 / 5 (33.3%) / 1 (6.7%) / 1 (6.7%) / 0 / 5 (33.3%) / 0 / 1 (6.7%) / 2 (13.3%) / 5 (33.3%)
Necrosis (N=1413) / Minimal necrosis (N=409) / Medical therapy (N=358) / 32 (8.9%) / 124 (34.6%) / 15 (4.2%) / 3 (0.8%) / 1 (0.3%) / 0 / 177 (49.4%) / 6 (1.7%) / 0 / 0
PCI (N=48) / 2 (4.2%) / 19 (39.6%) / 3 (6.3%) / 0 / 0 / 0 / 15 (31.3%) / 7 (14.6%) / 2 (4.2%) / 0
CABG (N=3) / 1 (33.3%) / 2 (66.7%) / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
Mild necrosis (N=450) / Medical therapy (N=381) / 0 / 27 (7.1%) / 7 (1.8%) / 40 (10.5%) / 4 (1.1%) / 0 / 40 (10.5%) / 244 (64.0%) / 19 (5.0%) / 0
PCI (N=58) / 0 / 6 (10.3%) / 2 (3.4%) / 6 (10.3%) / 0 / 0 / 5 (8.6%) / 35 (60.3%) / 4 (6.9%) / 0
CABG (N=11) / 1 (33.3%) / 0 / 0 / 1 (9.1%) / 0 / 0 / 4 (36.4%) / 6 (54.6%) / 0 / 0
Moderate necrosis (N=195) / Medical therapy (N=170) / 0 / 4 (2.4%) / 0 / 5 (2.9%) / 24 (14.1%) / 1 (0.6%) / 0 / 25 (14.7%) / 105 (61.8%) / 6 (3.5%)
PCI (N=23) / 0 / 0 / 0 / 2 (8.7%) / 3 (13.0%) / 0 / 0 / 6 (26.1%) / 11 (47.8%) / 1 (4.4%)
CABG (N=2) / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 (50.0%) / 1 (50.0%) / 0
Severe necrosis (N=359) / Medical therapy (N=297) / 0 / 1 (0.3%) / 0 / 3 (1.0%) / 1 (0.3%) / 30 (10.1%) / 0 / 3 (1.0%) / 23 (7.7%) / 236 (79.5%)
PCI (N=54) / 0 / 0 / 0 / 0 / 0 / 10 (18.5%) / 0 / 1 (1.9%) / 3 (5.6%) / 40 (74.1%)
CABG (N=8) / 0 / 0 / 0 / 1 (12.5%) / 0 / 2 (25.0%) / 0 / 0 / 1 (12.5%) / 4 (50.0%)

Table 3S. Patient-level comparison between index and serial myocardial perfusion imaging (MPI) highlighting changes in the prevalence of necrosis according to according to medical therapy versus intervening revascularization in the left anterior descending (LAD) territory or in the non-LAD territory.

Patients (N=3691) / Serial MPI
Normal (N=544) / Ischemia (N=1249) / Ischemia and necrosis / Necrosis
Minimal necrosis (N=97) / Mild necrosis (N=145) / Moderate necrosis (N=94) / Severe necrosis (N=118) / Minimal necrosis (N=406) / Mild necrosis (N=479) / Moderate necrosis (N=207) / Severe necrosis (N=352)
Index MPI / Normal (N=543) / Medical therapy (N=495) / 336 (67.9%) / 145 (29.3%) / 1 (0.2%) / 0 / 0 / 0 / 13 (2.6%) / 0 / 0 / 0
LAD revascularization (N=25) / 13 (52.0%) / 10 (40.0%) / 0 / 0 / 0 / 0 / 1 (4.0%) / 1 (4.0%) / 0 / 0
Non-LAD revascularization (N=23) / 10 (43.5%) / 12 (52.2%) / 0 / 0 / 0 / 0 / 1 (4.4%) / 0 / 0 / 0
Ischemia (N=1261) / Medical therapy (N=859) / 102 (11.9%) / 597 (69.5%) / 22 (2.6%) / 13 (1.5%) / 9 (1.1%) / 1 (0.1%) / 66 (7.7%) / 44 (5.1%) / 1 (0.1%) / 1 (0.1%)
LAD revascularization (N=191) / 24 (12.6%) / 109 (57.1%) / 8 (4.2%) / 6 (3.1%) / 2 (1.1%) / 0 / 17 (8.9%) / 23 (12.0%) / 2 (1.1%) / 0
Non-LAD revascularization (N=211) / 21 (10.0%) / 134 (63.5%) / 6 (2.8%) / 5 (2.4%) / 3 (1.4%) / 0 / 32 (15.2%) / 9 (4.3%) / 0 / 1 (0.5%)
Ischemia and necrosis (N=474) / Minimal necrosis (N=85) / Medical therapy (N=84) / 1 (1.9%) / 16 (30.2%) / 17 (32.1%) / 1 (1.9%) / 0 / 0 / 15 (28.3%) / 3 (5.7%) / 0 / 0
LAD revascularization (N=15) / 1 (6.7%) / 8 (53.3%) / 2 (12.3%) / 0 / 0 / 0 / 3 (20.0%) / 1 (6.7%) / 0 / 0
Non-LAD revascularization (N=17) / 1 (5.9%) / 7 (41.2%) / 5 (29.4%) / 0 / 0 / 0 / 3 (17.7%) / 1 (5.9%) / 0 / 0
Mild necrosis (N=146) / Medical therapy (N=84) / 0 / 10 (11.9%) / 3 (3.6%) / 36 (42.9%) / 3 (3.6%) / 0 / 7 (8.3%) / 25 (29.8%) / 0 / 0
LAD revascularization (N=34) / 0 / 4 (11.8%) / 3 (8.8%) / 6 (17.7%) / 0 / 0 / 4 (11.8%) / 15 (44.1%) / 2 (5.9%) / 0
Non-LAD revascularization (N=28) / 0 / 6 (21.4%) / 2 (7.1%) / 8 (28.6%) / 2 (7.1%) / 0 / 3 (10.7%) / 5 (17.9%) / 2 (7.1%) / 0
Moderate necrosis (N=93) / Medical therapy (N=61) / 0 / 3 (4.9%) / 0 / 8 (13.1%) / 26 (42.6%) / 5 (8.2%) / 0 / 6 (9.8%) / 12 (19.7%) / 1 (1.6%)
LAD revascularization (N=17) / 0 / 1 (5.9%) / 0 / 0 / 6 (35.3%) / 2 (11.8%) / 0 / 5 (29.4%) / 3 (17.7%) / 0
Non-LAD revascularization (N=15) / 0 / 2 (13.3%) / 0 / 0 / 5 (33.3%) / 2 (13.3%) / 0 / 1 (6.7%) / 3 (20.0%) / 2 (13.3%)
Severe necrosis (N=150) / Medical therapy (N=84) / 0 / 1 (1.2%) / 0 / 0 / 3 (3.6%) / 40 (47.6%) / 0 / 4 (4.8%) / 5 (6.0%) / 31 (36.9%)
LAD revascularization (N=36) / 0 / 1 (2.8%) / 1 (2.8%) / 1 (2.8%) / 0 / 11 (30.6%) / 0 / 2 (5.6%) / 4 (11.1%) / 16 (44.4%)
Non-LAD revascularization (N=30) / 0 / 0 / 0 / 0 / 2 (6.7%) / 14 (46.7%) / 0 / 0 / 1 (3.3%) / 13 (43.3%)
Necrosis (N=1413) / Minimal necrosis (N=409) / Medical therapy (N=358) / 32 (8.9%) / 124 (34.6%) / 15 (4.2%) / 3 (0.8%) / 1 (0.3%) / 0 / 177 (49.4%) / 6 (1.7%) / 0 / 0
LAD revascularization (N=24) / 3 (12.5%) / 9 (37.5%) / 0 / 0 / 0 / 0 / 7 (29.2%) / 4 (16.7%) / 1 (4.2%) / 0
Non-LAD revascularization (N=27) / 0 / 12 (44.4%) / 3 (11.1%) / 0 / 0 / 0 / 8 (29.6%) / 3 (11.1%) / 1 (3.7%) / 0
Mild necrosis (N=450) / Medical therapy (N=381) / 0 / 27 (7.1%) / 7 (1.8%) / 40 (10.5%) / 4 (1.1%) / 0 / 40 (10.5%) / 244 (64.0%) / 19 (5.0%) / 0
LAD revascularization (N=30) / 0 / 2 (6.7%) / 1 (3.3%) / 2 (6.7%) / 0 / 0 / 5 (16.7%) / 18 (60.0%) / 2 (6.7%) / 0
Non-LAD revascularization (N=39) / 0 / 4 (10.3%) / 1 (2.6%) / 5 (12.8%) / 0 / 0 / 4 (10.3%) / 23 (59.0%) / 2 (5.1%) / 0
Moderate necrosis (N=195) / Medical therapy (N=170) / 0 / 4 (2.4%) / 0 / 5 (2.9%) / 24 (14.1%) / 1 (0.6%) / 0 / 25 (14.7%) / 105 (61.8%) / 6 (3.5%)
LAD revascularization (N=11) / 0 / 0 / 0 / 1 (9.1%) / 2 (18.2%) / 0 / 0 / 3 (27.3%) / 5 (45.5%) / 0
Non-LAD revascularization (N=14) / 0 / 0 / 0 / 1 (7.1%) / 1 (7.1%) / 0 / 0 / 4 (28.6%) / 7 (50.0%) / 1 (7.1%)
Severe necrosis (N=359) / Medical therapy (N=297) / 0 / 1 (0.3%) / 0 / 3 (1.0%) / 1 (0.3%) / 30 (10.1%) / 0 / 3 (1.0%) / 23 (7.7%) / 236 (79.5%)
LAD revascularization (N=30) / 0 / 0 / 0 / 1 (3.3%) / 0 / 4 (13.3%) / 0 / 0 / 1 (3.3%) / 24 (80.0%)
Non-LAD revascularization (N=32) / 0 / 0 / 0 / 0 / 0 / 8 (25.0%) / 0 / 1 (3.1%) / 3 (9.4%) / 20 (62.5%)

Table 4S. Region-level comparison between index and serial myocardial perfusion imaging (MPI) highlighting changes in the prevalence of necrosis according to according to medical therapy versus intervening percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

Regions (N=25,837) / Serial MPI
Normal
(N=21,752) / Ischemia
(N=494) / Minimal necrosis
(N=899) / Mild necrosis
(N=1238) / Moderate necrosis
(N=589) / Severe necrosis
(N=865)
Index MPI / Normal
(N=19,787) / Medical therapy (N=15,729) / 15,429 (98.1%) / 47 (0.3%) / 137 (0.9%) / 81 (0.8%) / 16 (0.1%) / 19 (0.1%)
PCI (N=3412) / 3302 (96.8%) / 18 (0.5%) / 42 (1.2%) / 35 (1.0%) / 10 (0.3%) / 5 (0.2%)
CABG (N=646) / 618 (95.7%) / 3 (0.5%) / 18 (2.8%) / 6 (0.9%) / 0 / 1 (0.2%)
Ischemia
(N=2692) / Medical therapy (N=1551) / 1072 (69.1%) / 189 (12.2%) / 149 (9.6%) / 111 (7.2%) / 21 (1.4%) / 9 (0.6%)
PCI (N=867) / 637 (73.5%) / 93 (10.7%) / 74 (8.5%) / 51 (5.9%) / 9 (1.0%) / 3 (0.4%)
CABG (N=274) / 214 (78.1%) / 11 (4.0%) / 19 (6.9%) / 25 (9.1%) / 3 (1.1%) / 2 (0.7%)
Minimal necrosis (N=765) / Medical therapy (N=628) / 268 (42.7%) / 22 (3.5%) / 317 (50.5%) / 20 (3.2%) / 1 (0.2%) / 0
PCI (N=121) / 62 (51.2%) / 4 (3.3%) / 41 (33.9%) / 11 (9.1%) / 3 (2.5%) / 0
CABG (N=16) / 10 (62.5%) / 1 (6.3%) / 4 (25.0%) / 1 (6.3%) / 0 / 0
Mild
necrosis
(N=1132) / Medical therapy (N=882) / 60 (6.8%) / 54 (6.1%) / 74 (8.4%) / 627 (71.1%) / 58 (6.6%) / 9 (1.0%)
PCI (N=209) / 27 (12.9%) / 25 (12.0%) / 19 (9.1%) / 118 (56.5%) / 17 (8.1%) / 3 (1.4%)
CABG (N=41) / 8 (19.5%) / 0 / 5 (12.2%) / 23 (56.1%) / 4 (9.8%) / 1 (2.4%)
Moderate necrosis
(N=544) / Medical therapy (N=417) / 9 (2.2%) / 15 (3.6%) / 0 / 70 (16.8%) / 297 (71.2%) / 26 (6.2%)
PCI (N=111) / 5 (4.5%) / 3 (2.7%) / 0 / 28 (25.2%) / 64 (57.7%) / 11 (9.9%)
CABG (N=16) / 1 (6.3%) / 2 (12.5%) / 0 / 5 (31.3%) / 7 (43.8%) / 1 (6.3%)
Severe
necrosis
(N=917) / Medical therapy (N=687) / 22 (3.2%) / 5 (0.7%) / 0 / 20 (2.9%) / 58 (8.4%) / 582 (84.7%)
PCI (N=187) / 4 (2.1%) / 1 (0.5%) / 0 / 3 (1.6%) / 18 (9.6%) / 161 (86.1%)
CABG (N=43) / 4 (9.3%) / 1 (2.3%) / 0 / 3 (7.0%) / 3 (7.0%) / 32 (74.4%)

Table 5S.Comparison between index and serial myocardial perfusion imaging (MPI) highlighting changes in the prevalence of necrosis according to according to medical therapy versus intervening revascularization in the left anterior descending (LAD) territory or in the non-LAD territory.

Regions=25,837 / Serial MPI
Normal
(N=21,752) / Ischemia
(N=494) / Minimal necrosis
(N=899) / Mild necrosis
(N=1238) / Moderate necrosis
(N=589) / Severe necrosis
(N=865)
Index MPI / Normal
(N=19,787) / Medical therapy (N=15,729) / 15,429 (98.1%) / 47 (0.3%) / 137 (0.9%) / 81 (0.8%) / 16 (0.1%) / 19 (0.1%)
LAD revascularization (N=1914) / 1850 (96.7%) / 10 (0.5%) / 27 (1.4%) / 19 (1.0%) / 5 (0.3%) / 3 (0.2%)
Non-LAD revascularization (N=2144) / 2070 (96.6%) / 11 (0.5%) / 33 (1.5%) / 22 (1.0%) / 5 (0.2%) / 3 (0.1%)
Ischemia
(N=2692) / Medical therapy (N=1551) / 1072 (69.1%) / 189 (12.2%) / 149 (9.6%) / 111 (7.2%) / 21 (1.4%) / 9 (0.6%)
LAD revascularization (N=610) / 472 (77.4%) / 42 (6.9%) / 40 (6.6%) / 49 (8.0%) / 5 (0.8%) / 2 (0.3%)
Non-LAD revascularization (N=531) / 379 (71.4%) / 62 (11.7%) / 53 (10.0%) / 27 (5.1%) / 7 (1.3%) / 3 (0.6%)
Minimal necrosis (N=765) / Medical therapy (N=628) / 268 (42.7%) / 22 (3.5%) / 317 (50.5%) / 20 (3.2%) / 1 (0.2%) / 0
LAD revascularization (N=68) / 36 (52.9%) / 5 (7.4%) / 17 (25.0%) / 9 (13.2%) / 1 (1.5%) / 0
Non-LAD revascularization (N=69) / 36 (52.2%) / 0 / 28 (40.6%) / 3 (4.4%) / 2 (2.9%) / 0
Mild
necrosis
(N=1132) / Medical therapy (N=882) / 60 (6.8%) / 54 (6.1%) / 74 (8.4%) / 627 (71.1%) / 58 (6.6%) / 9 (1.0%)
LAD revascularization (N=122) / 16 (13.1%)) / 10 (8.2%) / 13 (10.7%) / 69 (56.6%) / 10 (8.2%) / 4 (3.3%)
Non-LAD revascularization (N=128) / 19 (14.8%) / 15 (11.7%) / 11 (8.6%) / 72 (56.3%) / 11 (8.6%) / 0
Moderate necrosis
(N=544) / Medical therapy (N=417) / 9 (2.2%) / 15 (3.6%) / 0 / 70 (16.8%) / 297 (71.2%) / 26 (6.2%)
LAD revascularization (N=62) / 5 (8.1%) / 1 (1.6%) / 0 / 13 (21.0%) / 37 (59.7%) / 6 (9.7%)
Non-LAD revascularization (N=65) / 1 (1.5%) / 4 (6.2%) / 0 / 20 (30.8%) / 34 (52.3%) / 6 (9.2%)
Severe
necrosis
(N=917) / Medical therapy (N=687) / 22 (3.2%) / 5 (0.7%) / 0 / 20 (2.9%) / 58 (8.4%) / 582 (84.7%)
LAD revascularization (N=115) / 6 (5.2%) / 2 (1.7%) / 0 / 5 (4.4%) / 8 (7.0%) / 94 (81.7%)
Non-LAD revascularization (N=115) / 2 (1.7%) / 0 / 0 / 1 (0.9%) / 13 (11.3%) / 99 (86.1%)

Table 6S. Patient-level comparison between index and serial myocardial perfusion imaging (MPI) highlighting changes in the prevalence of necrosis, pooling together patients with no, minimal or mild necrosis vs those with moderate or severe necrosis.

Patients (N=3691) / Serial MPI
No, minimal or mild necrosis
(N=3132) / Moderate or severe necrosis
(N=559)
Index MPI / No, minimal or mild necrosis
(N=3137) / 3009 (95.9%) / 128 (4.1%)
Moderate or severe necrosis
(N=554) / 123 (22.2%) / 431 (77.8%)

Table 7S. Region-level comparison between index and serial myocardial perfusion imaging (MPI) highlighting changes in the prevalence of necrosis, pooling together regions with no, minimal or mild necrosis vs those with moderate or severe necrosis.

Regions (N=25,837) / Serial MPI
No, minimal or mild necrosis
(N=24,383) / Moderate or severe necrosis
(N=1454)
Index MPI / No, minimal or mild necrosis
(N=24,376)) / 24182 (99.2%) / 194 (0.8%)
Moderate or severe necrosis
(N=1461) / 201 (13.8%) / 1260 (86.2%)

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