Evidence map›Paper›PMID 36639611›Full record

ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2023

Does financial hardship associate with abnormal quantitative myocardial perfusion and major adverse cardiovascular event?

Danai Kitkungvan, Nils P Johnson, Linh Bui, Monica B Patel, Amanda E Roby, Mary Haynie, Richard Kirkeeide, Susan Hood, K Lance Gould

Abstract read
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In one paragraph

Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
1.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Danai KitkungvanDivision of Cardiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
Nils P JohnsonDivision of Cardiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
Linh BuiDivision of Cardiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
Monica B PatelDivision of Cardiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
Amanda E RobyWeatherhead PET Center For Preventing and Reversing Atherosclerosis, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
Mary HaynieWeatherhead PET Center For Preventing and Reversing Atherosclerosis, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
Richard KirkeeideDivision of Cardiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
Susan HoodWeatherhead PET Center For Preventing and Reversing Atherosclerosis, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
K Lance GouldDivision of Cardiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA. K.Lance.Gould@uth.tmc.edu.
The University of Texas Health Science Center at Houston · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundData on impact of financial hardship on coronary artery disease (CAD) remain incomplete.

methodsConsecutive subjects referred for clinical rest/stress cardiac positron emission tomography (PET) were enrolled. Financial hardship is defined as patients' inability to pay for their out-of-pocket expense for cardiac PET. Abnormal cardiac PET is defined as at least moderate relative perfusion defects at stress involving > 10% of the left ventricle or global coronary flow reserve ≤ 2.0. Patients were followed for major adverse cardiovascular event (MACE) comprised of all-cause mortality, non-fatal myocardial infarction, and late coronary revascularization.

resultsWe analyzed a total of 4173 patients with mean age 65.6 ± 11.3 years, 72.2% men, and 93.6% reported as having medical insurance. Of these, 504 (12.1%) patients had financial hardship. On multivariable analysis, financial hardship associated with abnormal cardiac PET (odds ratio 1.377, p = 0.004) and MACE (hazard ratio 1.432, p = 0.010) and its association with MACE was mostly through direct effect with small proportion mediated by abnormal cardiac PET or known CAD.

conclusionAmong patients referred for cardiac rest/stress PET, financial hardship independently associates with myocardial perfusion abnormalities and MACE; however, its effect on MACE is largely not mediated by abnormal myocardial perfusion or known CAD suggesting distinct impact of financial hardship beyond traditional risk factors and CAD that deserves attention and intervention to effectively reduced adverse outcomes. Having medical insurance does not consistently protect from financial hardship and a more preventive-oriented restructuring may provide better outcomes at lower cost.

Indexed as

Coronary Artery DiseaseMyocardial InfarctionMyocardial Perfusion ImagingAgedFemaleFinancial StressHumansMaleMiddle AgedPositron-Emission TomographyPrognosisTomography, X-Ray ComputedCADDiagnostic and prognostic applicationDiseases/processesModalitiesMyocardial blood flowOutcomesPETTests

Identifiers

PMID36639611
OpenAlexW4315881671

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.