The authors applied an automated algorithm to derive the splenic ratio, a marker of how adequately a patient was stressed pharmacologically, in 16,650 patients from the REFINE PET registry followed for a median 3.4 years. A high splenic ratio was associated with major adverse cardiovascular events in the testing cohort (HR 1.19, 1.06-1.34), and more strongly where perfusion was otherwise reassuring (HR 1.54, 1.26-1.88). The measure needs no manual input and held after adjustment for clinical and imaging covariates.
Why it is interesting: A by-product of an existing scan separates risk among patients whose imaging is otherwise read as reassuring.